NYMC Faculty Member Joins Team to Develop Alternate Form of Ventilation Amid COVID-19 Crisis
For the past several weeks, Albert Kwon, M.D., assistant professor of anesthesiology, has taken a step back from his critical role as an anesthesiologist at Westchester Medical Center to work on a critically important research project with equally lifesaving prospects.
As the acute need for ventilators amid the COVID-19 health crisis emerged and with the potential looming for a shortfall of thousands of units, a group of MIT engineers, teaming with doctors with clinical experience in treating respiratory conditions, looked to a ten-year-old design for an inexpensive alternative for ventilation as the possible solution. This alternate design sought to automate the standard manual process of squeezing by hand an emergency resuscitator bag (known as an Ambu bag), currently readily available in large numbers at hospitals.
Dr. Kwon, an MIT alumnus, first heard about the project during a call to a professional colleague on an unrelated matter and was quickly recruited to become part of team. Initially he was tasked with running an animal study on pigs to validate the functionalities of a ventilator.
“Given the rapid pace and fluidity of the project, I had to learn many skill sets on the fly and execute in real time,” he says. “The research group did not have a mechanical model lung simulator and a local pig lab in Massachusetts offered access. I had multiple animal study experiences from college and medical school on mice, rats and rabbits, but it was a first time designing and executing studies on pigs all on my own.”
When the initial prototype showed itself to be inadequate from a mechanical and control standpoint in comparison to an ICU ventilator, Dr. Kwon’s expertise as a clinician became invaluable as he taught the engineers about respiratory physiology, the clinical goals of mechanical ventilation and how conventional ventilators work.
“We discussed how we might prioritize and implement the various functionalities of a ventilator in a short matter of time,” says Dr. Kwon. “It was a rapid iterative process of identifying problems, designing a solution and validating them in the animal lab. After four rounds of pig studies, we had a very robust core technology working.”
It was at that point that Dr. Kwon transitioned to working with industry groups in New York City (NYC) to productize the core engine developed by MIT. The NYC ventilator response consortium consisted of industry partners, a philanthropic organization, NYC Economic Development Corporation, MIT engineers and several academic physician scientists.
On April 17, the NYC consortium obtained FDA Emergency Use Authorization for the new device, Spiro Wave, to be used on patients in hospitals, just four weeks after the team first convened. While the device cannot replace a full-featured ventilator, Spiro Wave acts as a bridge device, offering key ventilation functions to help less critically ill patients breathe, so that health care facilities can better ration their ICU ventilators.
Though the need for ventilators in the New York City area has eased somewhat, the NYC response consortium is already forging ahead to implement the Spiro Wave in neighboring states and developing countries that lack advanced medical equipment, where the virus has yet to reach peak levels.
“I would love to stay involved in research related to this area and continue to build a better automated resuscitator device that is suitable for global health, emergency medicine and military applications,” says Dr. Kwon. “There is certainly great potential.”
Since news of the device has spread, the team has received many inquiries from foreign countries and New York Medical College students are now involved in helping to field those inquiries.
"The potential for ventilators shortages in the wake of COVID-19 is a global issue. When I learned about Dr. Kwon's involvement with the MIT project, I knew this would be a unique opportunity to contribute to solving this widespread problem,” says Melanie Winters, School of Medicine Class of 2020. “By sharing our clinical knowledge with MIT engineers, we have fostered a collaborative environment and expanded upon the device's function."
Many other students appear to feel the same way as 35 have already signed on to volunteer for a range of projects from monitoring inquiries and responding to clinical questions to revising the clinical content on the website and assisting Dr. Kwon with global interface with many non-English speaking countries.
“So far, this has been a wonderful educational opportunity and great exposure to product development. Dr. Kwon has effortlessly taken on a large group of students and provided us with a unique research opportunity,” says Ms. Winters, who is spearheading the student effort. “Once restrictions are lifted and we can return to campus, I would love to see this continue as a long-term project.”