Development of an Innovative Incentive Spirometer with Inbuilt Peep Providing Mechanism for Improving Lung Function in Tracheostomised Patients

INTRODUCTION: Tracheostomy is performed in patients expected to be on prolonged mechanical ventilation. In 2023, around 250000 tracheostomies and 161100 tracheostomies were performed in western countries and India respectively. While breathing through tracheostomy, nasal and oral cavity are bypassed which provides resistance during expiration, thought be crucial for physiological positive end-expiratory pressure (PEEP) development; smaller airways tend to collapse making the patient more prone to respiratory complications. If mechanical ventilation in continued PEEP can be provided but once weaned from ventilator, apart from manual recruitment (time consuming and labour intensive), mechanism to provide positive pressure recruitment is scarce. Commercial Incentive Spirometers mostly cannot be used in tracheostomised patients due to excessive resistance to the inspiratory flow. OBJECTIVE: To develop an innovative incentive spirometer which can be used in tracheostomized patients that will provide back-pressure recruitment of alveoli and decrease pulmonary complications. MATERIALS AND METHODS: Use Computer Aided Design, Computer Simulations and 3 D printing technologies to develop a prototype of innovative respiratory device. The device has a patented design that will mimic the natural breathing in tracheostomised patients. It will prevent collapse of alveoli, decrease respiratory complications,(1,2). decrease length of ICU stay and healthcare costs. RESULTS: We have developed a working prototype of the device and have done laboratory validation studies at IIT Guwahati. We have applied for CDSCO test license. Patent granted in India and South Africa. 3 D printed CAD design. Computer Fluid Dynamics Simulation data shows pressure at 30 WC at exhalation presses. Load is 1.08 N INLET AIR – 5 M/s. DISCUSSIONS/CONCLUSIONS: Innovative Respiratory System will provide positive pressure lung recruitment, improve lung function(3) and enable use of incentive spirometry in tracheostomised patients. The sensor-based version will also enable Bluetooth based real time monitoring of lung function.