ABI researchers to develop a more personalised approach to ventilator monitoring

Ventilators save lives, but treating patients with mechanical ventilators is not without risk.

Dr Haribalan Kumar, Auckland Bioengineering Institute (ABI), University of Auckland, plans to reduce that risk with a technology that will allow for more precise and dynamic monitoring of lung function at the bedside of a patient being treated with a ventilator. He and his team have received $150,000 from the Health Research Council’s Explorer Fund to do so.

A ventilator takes over the body’s breathing process when the lung begins to fail as it does when a patient has lung disease such as pneumonia, which has affected many Covid-19 patients. This gives patients time to recover from their condition.

However, mechanical ventilation involves using high pressures to pump oxygen into the tiny air sacs of the lung, which can save people’s lives but also cause lung injury, particularly if a patient requires long term treatment.

The monitoring of lung function (and adjusting the ventilators in response) is crucial to avoiding ventilator-related injury, particularly in critical care patients.

Without more precise monitoring, the greater the risk to the adverse effects of mechanical ventilation, which can affect the patient for life.

Dr Haribalan Kumar Auckland Bioengineering Institute

Such patients need bedside monitoring, but this is currently limited to measurements taken externally: pressure, volume and blood gases. “This makes it very difficult for clinicians to track how a patient is responding with any precision,” says Dr Kumar.

“It means they can only respond to significant changes in a patient; without more precise monitoring, the greater the risk to the adverse effects of mechanical ventilation, which can affect the patient for life.”

Building upon New Zealand’s reputation in modelling lung physiology and working with international collaborators, he and his team (including Professor Merryn Tawhai and Dr Alys Clark) hope to resolve this issue by combining patient-specific models of the lung with low-cost dynamic imaging.

Electrical Impedance Tomography (or EIT) is a technology that allows for imaging of the lungs inside the chest wall, by measuring signals from a belt of electrodes placed around the chest. EIT offers an imaging solution for continuous monitoring “but EIT has not been taken up widely because it has much lower resolution than other established imaging methods and it can be difficult to interpret,” says Dr Kumar.

He points out that differences in individual physiology (age, size, height, underlying health conditions etc.) mean that one lung is not like another, and this complicates the translation of measurements into a meaningful image.

Dr Kumar’s approach, if successful, will personalise the imaging information and improve its clinical value. “We hope our research will transform EIT from a potentially useful but difficult to interpret technology, to one that is personalised and easy for clinicians to use and interpret,” says Dr Kumar.

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