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University College London-Ventura CPAP breathing aids were developed by a team led by Professor Rebecca Shipley and Professor Tim Baker working with Mercedes-AMG High Performance Powertrains. The team manufactured 10,000 breathing aids for use in UK hospitals and shared the designs with organisations from 105 other countries at no cost. ©thisisjude.uk 2020

University College London-Ventura CPAP breathing aids were developed by a team led by Professor Rebecca Shipley and Professor Tim Baker working with Mercedes-AMG High Performance Powertrains. The team manufactured 10,000 breathing aids for use in UK hospitals and shared the designs with organisations from 105 other countries at no cost. ©thisisjude.uk 2020

As the number of COVID-19 cases surged in the UK and threatened to overwhelm the NHS, the UCL-Ventura team reverse-engineered, built, tested, obtained regulatory approval and manufactured 10,000 breathing aids for use in hospitals across the UK. The impact of this device has been so great that over 1,900 organisations from 105 countries around the world requested the designs to build their own devices. The designs were shared at no cost.

Engineering contribution

Early experiences from the front line in Italy and China suggested that a special breathing aid known as a Continuous Positive Airway Pressure (CPAP) device could help treat clinically ill COVID-19 patients. Medical data from these countries indicated that approximately 50% of patients given CPAP avoided the need for invasive mechanical ventilation, meaning a better outcome for patients and healthcare systems under pressure. Keen to learn from these experiences, the UCL-Ventura team was assembled, bringing together engineers at UCL and Mercedes-AMG High Performance Powertrains (HPP) with critical care consultants at University College London Hospital (UCLH).

The project group was pivotal to articulating this position nationally and, as a consequence, the NHS Care Pathway for COVID-19 changed to include CPAP by the end of March. The UCL-Ventura team then worked to remedy a national shortage of CPAP devices by focussing on reverse-engineering an off-patent breathing aid – a purely mechanical device based on the Venturi principle – which it then improved and manufactured at pace.

It took less than 100 hours from the first discussions about the concept to the first prototype being designed, manufactured and tested. Computer simulation and bench testing informed optimisation of the air-entrainment port and breathing circuit to minimise oxygen utilisation and improve patient comfort. The Mark I UCL Ventura gained MHRA approval in 10 days, with approval for the Mark II device following days later.

Engineers at Mercedes-AMG HPP provided manufacturing excellence, using machines that normally produce F1 engine components to create CPAP devices. Every unit was performance tested, with full traceability of all sub-components.

Impact

The UK government ordered 10,000 devices and the order was completed within 15 days, reaching over 60 NHS hospitals. During the production stage of the project, HPP manufactured over 1,000 devices per day to meet the demand as quickly as possible. Clinical data from UCLH shows, like it did in Italy, that half of patients treated with CPAP do not progress to invasive ventilation, making this device a lifesaver.

Professor Marcel Levi, Chief Executive at UCLH, says: "This has been one of the most effective, relevant, directly applicable and fastest projects I have ever witnessed. The absolute power of the team was undoubtedly its inter-disciplinary nature, bringing together top engineers, scientists, physiologists, respiratory experts and intensive care clinicians, in combination with inventiveness, intellect, ingenuity and unlimited energy.”

Ross Brawn, Managing Director of Motorsports at Formula 1 says: "As well as the foresight to identify the probable need for less invasive ventilation support...the team at UCL did something about it and committed to a programme at a point of time when some may have considered it to be, at best, speculative, but we now know to have been visionary.

"Formula 1 has an extreme culture of engineering in terms of solutions and time scales, and the fit with the UCL team was perfect. The design and delivery of 10,000 CPAP devices by HPP was in a time scale considered impossible by normal references, 15 days from the confirmation of order."

UCL-Ventura’s CPAP breathing devices are also making an impact abroad. To contribute to the global humanitarian effort, the multidisciplinary project team released full design and manufacturing instructions at no cost. These blueprints have been downloaded by more than 1,900 organisations from 105 countries.

Teams have begun manufacture and hospital testing of devices in Brazil, Bulgaria, Canada, Colombia, Ecuador, Germany, India, Iran, Mexico, Peru, Pakistan, Palestine, Philippines, Russia, South Africa and the US and the UCL-Ventura team continues to provide technical, manufacturing and clinical support, working with UK government teams.

"I have been enormously impressed by the drive, commitment and selfless dedication of Rebecca Shipley and the UCL team in supporting the UK and so many countries in the developing world in seeking to cope with this devastating pandemic," says Claire Burges Watson, Counsellor Political at the British High Commission in Nairobi.

"Not only have she and the team been very proactive in trying to provide a practical solution for a critical problem facing these countries, but they have worked hard to provide objective advice on the pros and cons of the CPAP. This reflects very well on their humanitarian commitment and our country’s reputation."