A new negative pressure ventilator

Award Information
Agency: Department of Health and Human Services
Branch: N/A
Contract: 1R43HL091587-01
Agency Tracking Number: HL091587
Amount: $103,588.00
Phase: Phase I
Program: SBIR
Awards Year: 2008
Solicitation Year: 2008
Solicitation Topic Code: N/A
Solicitation Number: PHS2007-2
Small Business Information
DUNS: 154920409
HUBZone Owned: Y
Woman Owned: Y
Socially and Economically Disadvantaged: Y
Principal Investigator
 (617) 868-4433
Business Contact
Phone: (617) 868-4433
Email: rlwhalen@wbmd.org
Research Institution
DESCRIPTION (provided by applicant): Long-term respiratory support using endotracheal intubation and positive pressure ventilation is associated with very high rates of infection, and ventilator-associated pneumonia (VAP) is among the leading and more seri ous forms of nosocomial infection in hospitals today. The objective of this program is the development of a new negative pressure ventilator that eliminates indwelling components and allows the patient to breathe room air to reduce the incidence of VAP. Th e prototype negative pressure ventilator is the iron lung originally developed by Drinker in 1929. It essentially consisted of a metal tank containing the patient's entire body up to the neck. The pressure inside the tank was cycled below ambient pressur e to induce inhalation, and then returned to ambient to allow exhalation. That device was used successfully to support many patients for extended periods during the polio epidemics in the late 1950s, but it was large, greatly limited access to the patient for routine nursing care, and provided a very limited quality of life. We are proposing to build and test prototypes of a new negative pressure ventilator that is small and light in weight. The principle of operation is the similar to the iron lung, but in stead of a tank, it employs a two-segment artificial rib cage assembly with an elastomeric jacket closely surrounding the chest wall. The artificial rib cage is mechanically actuated to mimic the movement of the chest wall during respiration, creating a ne gative pressure around the chest and upper abdomen during inhalation. Using a manikin, we have demonstrated that this design is able to generate negative pressures greater than -20 cm of water, enough to induce inhalation in an adult human subject. Because it is mechanically actuated, it may also be used to induce or augment a cough to clear the airways, a unique capability. In the proposed program, we will design and build prototypes of the device and develop an electronic control system that will permit e ither patient triggered fixed rate operation. We will then characterize its performance with a series of 6 acute in vivo studies using a porcine model. The new device overcomes many of the limitations of existing negative or positive pressure ventilation s ystems and has the potential to significantly reduce the incidence of VAP. PUBLIC HEALTH RELEVANCE: The objective of this proposal is the development of a novel negative pressure ventilator that will provide respiratory support without endotracheal intubat ion or the use of a conventional positive pressure ventilator. The latter devices are associated with high rates of infection (gt60%) when used for periods exceeding 30 days, and ventilator-associated pneumonia is one of the major classes of nosocomial inf ection and causes significant morbidity. By introducing no indwelling components into the airway and allowing the patient to breathe room air, the infection rate associated with prolonged respiratory support can be significantly reduced.

* Information listed above is at the time of submission. *

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