Advanced Test Methods for Medical Devices used in Pediatric Respiratory Support

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The long-term goal of the proposed research program is to improve the design and performance of medical gas delivery devices used in supporting pediatric patients suffering from respiratory diseases.  Childhood respiratory diseases present a major burden on global health.  Therapies and devices used for providing respiratory support to neonates, infants, and young children are critically important both in alleviating acute respiratory distress and treating chronic respiratory disorders. Despite the frequent need to provide respiratory support to young children, optimal device designs and delivery parameters for children are not well established.  Even for low-flow oxygen supplied through nasal prongs, used for decades as a standard therapy, estimates of inhaled oxygen concentrations are not well established for children.  For nasal high flow therapy, a relatively new form of noninvasive respiratory support which has seen rapid increase in use over recent years, little consensus exists regarding how interplay between device design, delivered flow rates, and patient airway geometry influences therapy. In recent years, the applicant's research group has done extensive work developing benchtop test methods for evaluating medical gas delivery devices.  The present research proposal aims to extend this work to address specific applications involving the treatment of neonates, infants, and young children. This work will focus on improving mechanistic understanding of nasal high flow therapy and low-flow oxygen therapy.  In carrying out the proposed research, experiments will be conducted in a laboratory environment using custom-built realistic pediatric nose-throat airway replicas coupled with a lung simulator.  Experiments will be conducted to evaluate existing commercial devices and patient interfaces, in order to improve prediction of gas concentrations and airway pressures delivered to children.   In addition, insights gained from evaluating existing devices will be used to propose novel, prototype device and interface designs. In all cases, experimental data will be compared with empirical and analytical models describing dependence of airway pressure and gas concentrations on delivered gas flow rates, upper airway geometry, and interface geometry (e.g. size and shape of nasal prongs), so as to validate predictive models that assist in early stage device and interface development. Results of the proposed research program will be of value to engineers working in the medical devices industry to evaluate and improve upon existing device designs, as well as to biomedical engineers, technologists and clinicians working within health systems to establish recommendations for selecting device and delivery parameters.  Students trained in the program will be well positioned to start their careers in the medical device industry.