Dr. Yasser Khan recently shared his experience in developing a portable CPAP/BiPAP machine to be used with COVID patients with HelmetBasedVentilaton.com co-founder Aurika Savickaite. Khan, born in Bangladesh, came to the United States for his undergrad and went to Saudi Arabi for his masters.
The project began when he saw the dire need for ventilation for patients in poorer countries like Bangladesh.
“It’s actually quite challenging in Bangladesh,” he said. “We didn’t expect the cases to surge as much – and now it’s surging really fast.”
The lack of accessibility to treatment is even more challenging for COVID patients. Doctors are overworked, as well.
He reached out to many friends to help with the project – from financials, logistics, or technical needs.
“Every email I sent, I got a ‘yes’ response back,” he said. “This is a community effort … it’s not just me, … it’s everyone, whenever we asked for help.”
In the beginning, the men found that intubation with patients in these countries would be difficult because there were not enough ICUs combined with a lack of trained medical personnel.
“That’s why we started focusing on non-invasive ventilation,” Khan said.
It was essentially a volunteer project, Khan said, utilizing the help of students, and researchers in the Bay area. Engineers from Bangladesh and working at Stanford and Berkeley soon joined the project, Khan said.
“We started looking into how can we create a low-cost solution that can be deployed in a country where we don’t have enough medical resources,” Khan said.
That led to work on the CPAP/BiPAP machine, which does not need a compressed air source.
With an invasive ventilator, an air source which is high pressure/high flow is needed from the wall -- available from developed countries – but much less available in underdeveloped countries.
“With CPAP/BiPAP, you use a blower, so essentially you have the source within the unit, so that is one of the biggest benefits of having this solution,” Khan said.
“Another thing is we needed to make something which is low-cost, portable, and easy-to-use,” Khan said. “These are extremely important factors because if it’s expensive, we cannot afford it. If it’s hard to use, we cannot give it to doctors to train.”
Portability was important in order to get the unit in as many hospitals as possible.
Working around the clock for several weeks, the team worked to meet those criteria, testing out different blowers and motors, and within six weeks, developed a small unit which met all the needs.
The self-contained unit – easily held in one hand, includes a blower and compressor and has a touch screen display to provide easy set-up and use.
The challenge was making the unit useful for COVID patients without contaminating the unit.
“At that time, on your website, we found that helmet-based ventilation is a good option,” Khan said, explaining the aerosolization of the virus is contained. Once this option was explained to leery physicians, the doctors changed their mind. “Then they became super excited -- they started telling us ‘we need this immediately’,” Khan said.
Khan described the progress as the end of phase one, with test units now in Bangladesh.
“We have a medical team over there (and) they are going to test the units,” he said. “Once we have feedback from them, then we will plan the next step.”
Khan said communication with the patient is important, to keep them calm and informed. He also found the ease of getting the helmet on and off, and the access ports make it easy to keep the treatment interrupted, as well.
Aurika described the compact machine as life-saving – stating how the unit can deliver the flow at a max rate of 180 liters per minute – something usually only seen in large facilities.
The units are now in a 2,600-bed teaching/research hospital in Bangladesh. COVID patients follow a protocol and that research will be used to fine-tune the design.
Currently, the unit costs about $200 per unit made in the small research lab – but Khan hopes with high-volume production will lower that cost, in addition to more cost-reducing strategies. Alarms also alert medical staff to disconnects, a plus for the staff working with the patients.
“Hopefully, once the design is validated by the doctors, one of the manufacturers can take the design and start making this in bulk,” Khan said. “That will actually reduce the cost. That’s our plan.”
Kahn also is looking for feedback from patients and physicians to help improve the machine.
Once the unit is validated and specs are confirmed, the design will be open to be shared with others, Khan said. There also are plans to have the unit FDA-approved, he said. FDA-approved devices can often get faster approval in other countries.
“This is an all hands-on-deck project,” Khan said. “Everyone is chipping in on this. It’s not just Bangladesh. Once we go through the whole thing, we can share our story, share our design. The other countries can also pick that up.”
“That will help all the countries, not just Bangladesh.”
The challenges are felt around the world, Khan said.
“It’s quite daunting for the whole country (Bangladesh),’ he said. “The government is trying,” Khan said. “The problem is the whole world is suffering.
“Since the whole world is suffering, it’s hard to mobilize help from other countries to help countries in need. It’s a huge challenge, I think it’s the biggest challenge of our lifetime.”