As the developer of Pennsylvania College of Technology's additive manufacturing curriculum, Eric K. Albert has preached to his students for years about the ingenuity facilitated by 3D printing. A few months from retirement, he's proving his point by responding to the COVID-19 pandemic.
The associate professor of automated manufacturing and machining has used his own materials and 3D printer to produce eight non-FDA approved ventilator splitters made of ABS, a widely used engineering resin, that could – in a worst-case scenario – allow a facility to connect more than one patient to a ventilator.
"I'm trying to get ahead of the curve," Albert said. "Hopefully, they won't have to be used. If requested, I could make about 48 more in a couple days in our lab at the college. I can't produce thousands, but I'm happy to do whatever I can.
"The beauty of additive manufacturing is its flexibility. I can shift from a face shield to a ventilator splitter just by changing the computer files."
Earlier this week, Albert made more than two dozen face shields on the college's Stratasys 3D printers. The face shields are being distributed to the college's nursing home partners.
Albert got the idea and the free files to manufacture the splitter from ventsplitter.org, a group consisting of four anesthesiologists from San Antonio. The doctors developed the splitter to help mitigate the shortage of ventilators resulting from the COVID-19 pandemic, a respiratory illness.
The Society of Critical Care Medicine projects that 960,000 coronavirus patients in the U.S. may need a ventilator. The organization estimates that acute care hospitals own 62,000 full-featured mechanical ventilators and 98,738 more basic models.
According to the Center for Public Integrity, the Strategic National Stockpile consists of about 16,000 ventilators for emergency deployment.
"A ventilator is required when all other means of oxygenation have failed, such as BiPAP/CPAP machines," said Joel Brooks, learning lab coordinator for nursing education at Penn College and an intensive care unit nurse at UPMC Susquehanna in Williamsport. "The patient is sedated and an endotracheal tube, which will be connected to a ventilator, is inserted in the lungs via the mouth. Oxygen, supplied by the ventilator, is then put directly into the lungs via the endotracheal tube. Air in the atmosphere contains roughly 21% oxygen. A ventilator can supply up to 100% oxygen.
"Sometimes people use the terms 'ventilator' and 'respirator' interchangeably, but respirators are different. A respirator is a mask that prevents wearers from inhaling potentially harmful airborne particles."
Ventilators are intended for single-patient use, and the vent splitter should "only be used when imminent risk of death is otherwise unavoidable and complete occupancy of ventilators has been reached," said Bryan Lai, one of the anesthesiologists who developed the device.
A 2006 study published in the Society for Academic Emergency Medicine detailed how T-tubes and adapters could be employed to divide a ventilator circuit, so multiple patients could share a single ventilator in emergency situations. After referencing that study in mid-March, Lai said he discovered that a "large local hospital" didn't have the T-tubes and other parts necessary to convert a ventilator for multi-patient use.
That revelation prompted Lai to spend the next few days designing and refining a splitter as a substitute for the parts required to convent a ventilator. On March 22, Lai tested the splitter on ventilators, and it worked as intended with simulated lungs. Lai and his colleagues launched ventsplitter.org the following day, offering for free the files required to 3D print the vent splitter.
"We are undergoing active talks with the FDA on receiving emergency-use approval," Lai said. "We fully expect to receive this, especially given the current crisis."
Two vent splitters allow a single ventilator to serve two patients. Six splitters are required to ventilate four patients.
"We have received direct confirmation that the vent splitter is being used in the United States," Lai said. "I have been asked for the time being to not disclose the hospital systems employing this."
Lai said the vent splitter files have been downloaded more than 4,000 times and that his group has received feedback via the website from throughout the United States and several countries.
Albert is one of the individuals who has provided feedback. He's waiting for ventsplitter.org to recommend a facility to send the splitters that he has manufactured.
"I certainly didn't anticipate spending my last weeks at Penn College making parts to help combat a pandemic," said Albert, who is scheduled to retire in August after a 30-year career at the college. "But I'm proud how a field I devoted my professional life to is playing an important role in that fight."
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