Mechanical Augmentation of the Diaphragm for End-Stage Respiratory Failure

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Abstract Severe respiratory muscle weakness, specifically diaphragm dysfunction, can arise from many conditions, including trauma and neuromuscular disorders. Patients with diaphragm dysfunction experience respiratory failure due to “pump failure”, in which the mechanical pumping function of the respiratory muscles fail to generate the necessary motion and pressure gradients to drive respiratory ventilation, specifically inspiration. Moderate respiratory failure may be addressed with non-invasive ventilation, however if non-invasive ventilation techniques fail, invasive ventilation via tracheostomy is currently the only other option. Invasive ventilation is often declined by the patient due to the interference with quality of life. The major long-term goal of this project is to develop of an alternative therapeutic ventilation option based on medical soft robotics: an “implantable ventilator” based on augmenting diaphragm motion. We chose to use soft robotic actuators as they can interact nondestructively with biological tissues and can augment the mechanical motion of muscles. In order to achieve the overall objective we will build a pressurized benchtop testbed of the diaphragm to allow for rapid prototyping and testing as there is currently a lack of in vitro models of diaphragm biomechanics. We will iteratively design and test our device prototypes in the in vitro set up and in situ within pig cadavers to optimize device function. We will evaluate the final device within an in vivo porcine model. Such a device may provide patients with end-stage mechanical respiratory failure an alternative therapeutic option to invasive ventilation.