By Abdul Qadir Qureshi
Aga Khan University will launch a clinical trial of a portable, low-cost ventilator that aims to make lifesaving treatment such as assisted breathing available to patients before they reach the hospital. Ventilators are currently only available in hospitals even though most patients with critical breathing problems need earlier access to breathing assistance.
AKUs briefcase-sized, battery-operated ventilator is designed to be used in an ambulance to reduce existing delays in receiving care.
Every moment is vital when youre struggling to breathe, said Saleem Sayani, director of the AKUs Technology Innovation Support Centre and Digital Health Resource Centre. Most people with severe respiratory issues see their health deteriorate on their way to the hospital and they typically need more breathing assistance than a simple oxygen cylinder can provide.
Pakistan also has a high burden of respiratory diseases with pneumonia and chronic obstructive pulmonary disease, COPD, being two of the top ten leading causes of death, according to the Global Burden of Disease Study 2019. People with severe forms of pneumonia, COPD and COVID-19 are among those who require urgent access to ventilation.
A third of all patients in low and middle income countries require care such as assisted ventilation before reaching the hospital, according to the World Health Organization. Besides those with breathing problems, individuals suffering from head injuries, drug overdoses and heart conditions can also benefit from ventilators in ambulances.
Too many precious lives are lost due to a lack of timely and effective ventilation, said Dr Junaid Razzak, director of AKUs Center of Excellence for Trauma and Emergencies. This innovation aims to bridge the gap in care during transport to the hospital, which is often the period of highest risk for critically ill patients.
Early tests show that the prototype ventilator can provide a regular supply of oxygen that can stabilise the health of a high-fidelity patient mannequin mimicking the symptoms of a patient with respiratory issues. Clinical trials aim to evaluate the safety and efficacy of the device among patients with chronic breathing problems in ambulances and emergency rooms.
The prototype device also has a mobile app that allows doctors at the hospital to manage the ventilators settings while the patient is in the ambulance to ensure that s/he reaches the hospital in a stable condition. Hospital staff can also access real-time data about the patients health through the app enabling them to take appropriate actions before his or her arrival at the emergency room.
All the data available on the app in the ambulance is visible to specialists in the hospital. This will enable more efficient triage, diagnosis and treatment for critically ill patients.
The ventilators app also contains an artificial intelligence component that evaluates the patients data, assesses the risk to a health and provides suggestions on the next steps to be taken by the ambulance paramedic.
The use of low-cost mobile ventilators in ambulances coupled with remote monitoring from the hospital through mobile technologies has the potential to significantly improve patient outcomes and increase chances of survival, particularly in low-resource countries like Pakistan, said Dr Asad Latif, chair of the department of anaesthesiology at AKUs Medical College.
The objectives of the clinical trial are in line with global efforts under the UN Sustainable Development Goal 3 to reduce premature mortality from communicable diseases such as pneumonia and non-communicable diseases such as asthma and COPD.