Delivery of CPAP respiratory support for COVID-19 using repurposed technologies

Culmer, Peter; Keeling, Andrew; Osnes, Cecilie; Birch, William Davis; Jones, Daniel; Waters, Ian; Hetherington, R.; Parmar, J.; Lawton, Tom; Ashton, S.; Latham, M.; Murdoch, Stuart; Brettle, D S; Kapur, Nikil

doi:10.1101/2020.04.06.20055665

Cited by 2 publications

(2 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The breathing circuit has a dead space of ~320 ml (comprising the volume of the mask and breathing circuit up to the expiratory port). The breathing circuit was implemented under the guidance of the clinical team within the Leeds NHS Teaching Hospital Trust and Bradford NHS Teaching Hospital Trust for treatment of patients with Covid-19 and adopted nationally within the UK ( 4 , 28 ).…”

Section: System Developmentmentioning

confidence: 99%

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation

Culmer

Birch

Waters

et al. 2021

Front. Med. Technol.

Self Cite

View full text Add to dashboard Cite

Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed a significant demand on healthcare providers (HCPs) to provide respiratory support for patients with moderate to severe symptoms. Continuous Positive Airway Pressure (CPAP) non-invasive ventilation can help patients with moderate symptoms to avoid the need for invasive ventilation in intensive care. However, existing CPAP systems can be complex (and thus expensive) or require high levels of oxygen, limiting their use in resource-stretched environments.Technical Development + Testing: The LeVe (“Light”) CPAP system was developed using principles of frugal innovation to produce a solution of low complexity and high resource efficiency. The LeVe system exploits the air flow dynamics of electric fan blowers which are inherently suited to delivery of positive pressure at appropriate flow rates for CPAP. Laboratory evaluation demonstrated that performance of the LeVe system was equivalent to other commercially available systems used to deliver CPAP, achieving a 10 cm H2O target pressure within 2.4% RMS error and 50–70% FiO2 dependent with 10 L/min oxygen from a commercial concentrator.Pilot Evaluation: The LeVe CPAP system was tested to evaluate safety and acceptability in a group of ten healthy volunteers at Mengo Hospital in Kampala, Uganda. The study demonstrated that the system can be used safely without inducing hypoxia or hypercapnia and that its use was well-tolerated by users, with no adverse events reported.Conclusions: To provide respiratory support for the high patient numbers associated with the COVID-19 pandemic, healthcare providers require resource efficient solutions. We have shown that this can be achieved through frugal engineering of a CPAP ventilation system, in a system which is safe for use and well-tolerated in healthy volunteers. This approach may also benefit other respiratory conditions which often go unaddressed in Low and Middle Income Countries (LMICs) for want of context-appropriate technology designed for the limited oxygen resources available.

show abstract

Section: System Developmentmentioning

confidence: 99%

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation

Culmer

Birch

Waters

et al. 2021

Front. Med. Technol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The LeVe CPAP breathing circuit integrates the LeVe flow generator, to give an oxygen efficient breathing circuit, as shown Figure 4a. The circuit was implemented under the guidance of the clinical team within the Leeds NHS Teaching Hospital Trust and Bradford NHS Teaching Hospital Trust for treatment of patients with Covid-19 and adopted nationally within the UK [16], [21]. From the LeVe flow generator, there will be a constant flow of air through the expiration port.…”

Section: System Developmentmentioning

confidence: 99%

The LeVe CPAP System for oxygen-efficient CPAP respiratory support: Development and pilot evaluation

Culmer

Birch

Waters

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed a significant demand on healthcare providers (HCPs) to provide respiratory support for patients with moderate to severe symptoms. Continuous Positive Airway Pressure (CPAP) non-invasive ventilation can help patients with moderate symptoms to avoid the need for invasive ventilation in intensive care. However, existing CPAP systems can be complex (and thus expensive) or require high levels of oxygen, limiting their use in resource-stretched environments. Technical Development + Testing: The LeVe (Light) CPAP system was developed using principles of frugal innovation to produce a solution of low complexity and high resource efficiency. The LeVe system exploits the air flow dynamics of electric fan blowers which are inherently suited to delivery of positive pressure at appropriate flow rates for CPAP. Laboratory evaluation demonstrated that performance of the LeVe system was equivalent to other commercially available systems used to deliver CPAP. Pilot Evaluation: The LeVe CPAP system was tested to evaluate safety and acceptability in a group of ten healthy volunteers at Mengo Hospital in Kampala, Uganda. The study demonstrated that the system can be used safely without inducing hypoxia or hypercapnia and that its use was well tolerated by users, with no adverse events reported. Conclusions: CPAP ventilation systems provide an important treatment option for COVID-19 patients. To deliver this for the high patient numbers associated with the COVID-19 pandemic, healthcare providers require resource efficient solutions. We have shown that this can be achieved through frugal engineering of a CPAP ventilation system, in a system which is safe for use and well tolerated in healthy volunteers. This approach may also benefit other respiratory conditions which often go unaddressed in LMICs for want of context-appropriate technology.

show abstract

Delivery of CPAP respiratory support for COVID-19 using repurposed technologies

Cited by 2 publications

References 2 publications

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation

The LeVe CPAP System for oxygen-efficient CPAP respiratory support: Development and pilot evaluation

Contact Info

Product

Resources

About