As the world finds itself in a medical arms race against the COVID-19 pandemic, some good news from Spain, where the first ever 3D-printed respirator has just been medically approved. The Leitat 1 is now in the process of being rolled out across the country to help ease the burden on Spanish healthcare, but are we likely to see it in the UK anytime soon? Here, Dr Manel Balcells, Health Commissioner at Leitat Technological Centre and Director of CIMTI – a centre for the integration of medicine and innovative technology – explains both the process and the potential around creating this kind of life-saving machine.
How are you doing out in Barcelona?
Tired but ok, thank you. We’re on lockdown here, and will be for at least another two weeks, but as a doctor I can still go to the hospital for work. Honestly, it’s been intense – we’ve had 50 people from many different disciplines working incredibly hard on this project. The nuclear team have been working around the clock, getting only four or five hours of sleep a night. Everyone is shattered, but yesterday we were very happy because we finally got to the end of this first step, where we’d created a 3D-printed ventilator and received medical approval. Now, the next step is getting these respirators into hospitals.
How long do you reckon that is going to take?
We’re now at the point where we can start production, so in two days, 20 respirators will be in five hospitals, in four days we will have 200 respirators in different Spanish hospitals. The whole process has taken under two weeks – we designed the prototype in three days, and within eight we’d had the design clinically approved in the labs. It’s now ready for mass production. The printing process takes about 12 hours to make all the different parts, then we have to assemble each one using the other purchased components, like the bag and the motor. We currently have the capacity to produce 100 a day, but hopefully many more soon.
So we’re likely to see it here in the UK soon?
Hopefully – we’ve been talking to the UK ambassador in Spain about it, but they haven’t put in an order yet. But the international reaction on the whole has been good so far, with a lot of people interested in the process. At the moment we have also had interest expressed from the United States, from Russia, from the Balkan countries and from South American countries. We’re in contact with them about how we can translate this project for them as the design needs a manual for use.
But the idea of a 3D-printed ventilator is a good solution for any country, particularly developing ones, as they can replicate it domestically. There’s no need to make them here then ship them. All you need is a 3D printer to replicate the design no matter where you are in the world, and the production cost is low – you can make one of these ventilators for under €500. That point is important to us as this is a purely philanthropic project – there’s no financial benefit for us. Our design will be open source so it can be freely shared. It’s simply our contribution to the current COVID-19 pandemic situation.
This project has brought together so many different people to work on it. Where did it all begin?
It started with a call from the Spanish sanitary authorities about how 3D printing might be able to help in this situation where there simply aren’t enough respirators to go around. At my technology centre we have a 3D incubator project so there are a lot of engineers working in this field who we could speak to, but the truth is that a lot of countries have been chasing down a similar solution – it’s not only us who have been searching for it. For example, we modelled our prototype on an open source one from the Rice University in Houston, Texas, modifying the parameters to create an emergency respirator instead.
In the end we had physicians, nurses, engineers, electronic specialists working together to devise a way to make an emergency respirator using 3D printing that would respond this need. Doing it in such a short amount of time and at the lowest possible cost were two of the biggest challenges, alongside getting clinical validation. This usually delays the schedule for new medical gear or kills it dead in the water, but our design was validated by the Parc Taulí Hospital in Sabadell in their intensive care unit.
We learned a lot of things from this process, but most importantly we learned how we really can do interdisciplinary work. We had people with expertise in so many different areas, but seeing the synergy between everyone was a great lesson for the future. It’s been a team effort, but then a time of crisis like this needs everyone to pull together.
How does an emergency respirator like this differ to a standard one then?
The essential difference is that this ventilator is operated manually, whereas traditional, standard versions are automatic. The Leitat 1 also requires patients to be sedated, and you’ll need a specialist on hand to manually operate it with experience of intensive care. It’s a more basic model, but this is reflected in the price, as it’s probably 16 times cheaper than a traditional ventilator.
People need to remember that the one we have designed is only for critical situations. This is an emergency solution for an emergency situation – hospitals are still going to need traditional respirators. But this one will be good for emergency hospitals, like the one they are proposing in New York right now. Essentially this respirator can save lives – it can fill a gap in the market when there aren’t enough traditional respirators to meet the current demand.
So this isn’t something we should be relying on in the future?
No, but we have learned that 3D printing can be a solution for a lot of problems in the future as long as we can pull together to deliver it.
Realistically, everything will be different after this pandemic. There will be a clear line drawn between before and after. Because of the scale of the crisis, everything will need to be adapted going forwards. We will have to address our healthcare systems in particular, which will need to adopt new technologies, and our domiciliary care assistance will need to be better in the future. Medical professionals will also have different responsibilities going forward, thinking more about prevention rather than simply reaction to new emergencies in the future, whether that’s health or natural disasters.
But for now you must be celebrating the fact that your design has the potential to save a lot of lives?
No, we’re not celebrating yet. When everyone who needs a respirator has one, we’ll start the celebrations.