Industry News: WMG helps British taskforce develop UK negative pressure ventilator to assist recovery of COVID-19 patients

As the UK feels the impact of the current wave of coronavirus, the exovent task force unveils its UK negative pressure ventilator designed to assist the recovery of COVID-19 patients and for the treatment of Pneumonia and COPD.

The exovent task force formed in March 2020 in response to the COVID-19 crisis, inspired by calls from the UK Government for rapid innovation to combat the challenge presented by this highly contagious and aggressive disease. The team is composed of anaesthetists, critical care consultants, nurses, medical clinicians, engineers, academics, scientists and manufacturers.

exovent was not part of the UK Ventilator Challenge as this was conceived for positive pressure devices. Instead, the exovent team focused on exploring the benefits of negative pressure ventilation, founded upon lessons learned from nearly 100 years of Negative Pressure utilisation.

Thanks to the investment of over £1m of volunteer time, rapid engineering development and prototyping by Marshall ADG (the UK’s leading privately owned Aerospace and Defence business) and partnership with WMG High Value Manufacturing Catapult, a highly professional system is now available for approval.

The latest and most advanced iteration, the exovent-19, is ready to progress to approval by the Medicines and Healthcare products Regulatory Agency. Once approved, several leading intensive and respiratory care units stand ready to trial the system, including the Critical Care Research Team, Southampton NIHR Biomedical Research Centre (University Hospital Southampton & University of Southampton) and the Queen Elizabeth Hospital, King’s Lynn NHS Trust.

Recognising the applicability of the technology to developing countries, the team has also been partnering internationally with pioneer groups in Ghana, Bangladesh, and Ethiopia to help them develop local versions that can be approved and manufactured by them using locally sourced materials where possible. Marshall has shipped two of its protoype exovent machines designed and manufactured at its Cambridge headquarters, direct to Indian ventilator manufacturer, Skanray, who plan to use them, along with the supporting design information, to develop a relatively low cost production model that can be rapidly approved and developed for mass distribution in their local markets as quickly as possible.

exovent are hoping to come to an agreement with a UK based manufacturer in the coming weeks. In addition, the team plan to develop both a global low cost system and a paediatric low cost system working with UK engineering partners.

Speaking about the new system, exovent CEO, Ian Joesbury, stated:

“We are really excited to be unveiling this life-saving system which is a cutting-edge reinvention of pre-existing technology. In the UK I believe this can form part of a longer-term plan to treat COVID-19. As the patient does not need to be anaesthetised it opens up alternative treatment options that may allow more patients to be treated outside of intensive care.”

Dr Malcolm Coulthard, from the exovent team, said:

“From research and findings to date, we firmly believe that the use of negative pressure devices can transform the patient journey for COVID-19 patients and those with pneumonia and other diseases that affect breathing. The technology is safe, simple to use and systems could be built and deployed rapidly, in both the UK and overseas. Our recent paper published in the medical journal Anaesthesia demonstrates that the exovent-19 is twice as efficient as other negative pressure systems.”

Patrick Wood, Chief Technical Officer at Marshall ADG, shared:

“Our engineering team have designed a robust and reliable system using rapid prototyping methodology that enabled the first systems to be functionally tested within a few weeks of our first discussions. We look forward to seeing the system help patients across the globe once it is approved.”

Margot James, Executive Chair at WMG added: “I am very proud of WMG’s involvement in the development of exovent, the negative pressure ventilator promises to help more Covid patients be treated effectively as with established ventilator technology, whilst needing less oxygen and nursing resource. I congratulate the team of engineers and medics who have brought forward this innovation.”

How exovent works as an alternative treatment for COVID-19

One of the key features of COVID-19 is that it can cause pneumonia and acute respiratory failure, with over 2 million recorded deaths across the world by mid January 2021. Many countries, including the UK, took substantial action to mitigate the impact including putting in place support for ventilator production. However, whilst ventilators and high flow oxygen devices are clearly lifesaving, they are not without their challenges and may not be suitable for all patients, particularly the elderly.

In contrast, the exovent-19 has key benefits that make it particularly suitable to support COVID-19 patients. Use of negative pressure is far less intrusive and much more like normal breathing than either intubation or continuous positive airway pressure (CPAP). exovent-19 is non-invasive, which means that patients do not need to have their windpipes intubated, so they don’t need to be anaesthetised and oxygen can be delivered in the form of a normal oxygen mask or nasal prongs rather than through a high flow oxygen device that puts hospital oxygen supplies under pressure. Patients remain conscious, and can take medication and nutrition by mouth, and talk to loved ones on the phone.

exovent-19 works by being fitted over the patient’s torso and can operate in two modes, continuous negative extrathoracic pressure (CNEP), the negative pressure equivalent of CPAP, increases the volume of air in the lungs while the patient continues to breath for themselves by applying negative pressure to the outside of the patient’s chest and abdomen. Negative pressure ventilation (NPV) cycles that negative pressure and reduces the effort required for a patient to breath. The level of support can be increased or reduced progressively to help in the patient’s recovery. It also increases the heart’s efficiency compared to conventional ventilators which squeeze the chest and put pressure on the heart. The simple design concept for the exovent system makes it widely accessible with highly cost-effective, reliable units able to be readily manufactured and approved around the world.

Longer-term vision

The vision of the team is a world where everyone has access to non invasive breathing support when they need it. Recognising the important contribution that exovent systems can make in achieving this in the longer as well as the short term, the task force decided to register as a UK Charity. The team is very grateful to law firm Bates Wells who generously donated their time and expertise and to many other companies who have provided support.

The response of the Charity Commission was also enormously impressive - understanding the urgency, they registered the charity in just one working day. Charity Commission CEO, Helen Stephenson, later explained that like Bates Wells, her team was determined to do what they could to help the COVID effort and prioritised all COVID related applications.

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