COVID-19 has laid bare the extreme shortage of reliable oxygen therapies around the world. Ventilators are expensive and some countries began the pandemic with a baseline of less than 10 ventilators in the entire country.
Two solutions to address ventilator shortages that emerged during the early months of the pandemic were 1) to end ventilators to countries in need, and 2) to make ventilators locally. At Maternova, we partnered with a manufacturer of a rugged, military-grade ventilator to make one such solution available. Ventilators however, do require that a patient be 'intubated'-- a process that is invasive, stressful, and which aerosolizes COVID-19.
On the other end of innovation around Covid-19 oxygen treatment were the rapid deployment of novel solutions to deliver oxygen and pressure to the lungs. Here is where the helmet CPAP device sits, a solution that is meant to keep patients from entering into acute respiratory distress (ARDS) and to keep them from requiring ventilator intervention. Long used in Italy and in hospitals in some European countries, the respiratory circuit offers a perfect Maternova 'conundrum': a product with a good clinical history behind it, but one which had not been disseminated widely before COVID-19 hit. Spreading the word beyond geography and language became an imperative for Maternova in the midst of the pandemic.
The process of intubation (needed with ventilators) puts health workers at risk of the aerosolization of the virus. Intermediate solutions to increase positive airway pressure and increase oxygen are in demand in order to keep patients off ventilators, provide an alternative means of treatment when nasal cannula fail and a patient is hypoxemic or at risk of acute respiratory distress syndrome (ARDS). In a layperson's terms, the pressure exerted by a Helmet CPAP respiratory circuit can actually keep parts of the patients' lungs open, even with very littleoxygen flow. This method can actually be used to avoid ARDS and the ventilator. A recent Journal of Pulmonology publication includes the Helmet CPAP as part of a clinical algorithm for addressing COVID-19 respiratory distress.
Our manufacturing partner and the innovator behind a US FDA EUA approved hood had a prototype produced with in 2 weeks of the lockdown in the United States. The hood is manufactured with soft optically clear vinyl material that is ultrasonically welded to a flexible vinyl coated nylon fabric base, so that a patient can read or watch television during treatment. The base contains two 22 mm ports allowing for connection to standard 22 mm ventilator hoses. Optional treatment ports are also available. These features allow the patient to be fed and hydrated without removing the hood. Most importantly, the contained sphere within the plastic hood reduces the risk to health staff, as compared to either regular CPAP face mask or ventilators.
The oxygen hood can be used with wall oxygen, or with a mechanical ventilation device or Bipap device. One configuration available includes a Venturi valve. This novel respiratory circuit is already in use in major U.S. hospitals, ambulances, as well as in hospitals and clinics around the world. Please stay tuned as we track its use in Bolivia Nigeria, Bangladesh, USA and UAE, and as the use cases of this innovation rapidly unfold.
Please contact us at firstname.lastname@example.org for any inquires about the Helmet CPAP respiratory circuit, the literature behind it and the components needed for the circuit.
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.