Journey of indigenous ICU ventilator development project

Indigenous ICU ventilator - Make in India

As COVID-19 continues its relentless march across the globe, India has seen a sharp rise in cases threatening to overwhelm our hospitals and push our healthcare systems beyond their limits. Four months ago, when a national survey sounded the alarm, saying there were only 47,000 ventilators in the country, with imports costly and difficult, several minds decided to come together. The national appeal to promote ‘Make in India’ had to come to fruition. Moreover, it was the need of the hour to develop ventilators to address this very shortage.

Covid-19 frontline warriors at ICU, Ruby Hall Clinic

Innovate2BeatCOVID Grand Challenge

In March 2020, the Marico Innovation Foundation (MIF) under the leadership of Dr. Raghunath Mashelkar, announced the #Innovate2BeatCOVID Grand Challenge. It was then that Nocca Robotics and IIT Kanpur reached out to me for assistance. The challenge — they wanted us to guide and mentor them as they took up the task of developing an ICU ventilator. As an intensivist, I myself was in the midst of preparing our ICU at Ruby Hall Clinic, Pune to brace for the impact of Covid-19 pandemic, but looked at this challenge as an opportunity that would not only address the ventilator shortage but one which could significantly and positively impact the Make in India endeavour. I strongly believe that every innovative idea starts from powerful inspiration, and it was this very inspiration that propelled me to mentor and supervise the team.

Noccarc V310 ventilator by Nocca Robotics

Ventilator functioning

Firstly, it is important to establish the functionality of ventilators and how they are poised to help in times of a respiratory crisis. At its core, a ventilator is a simple machine, blowing oxygen-rich air into a body and removing carbon dioxide–loaded exhalations. The challenge for the engineering team was to ensure that it does that job consistently, and can precisely measure the volume, pressure, and timing of the breaths passing through a patient. If the air pressure entering a patient’s lungs is too low, the lungs could partially collapse and oxygen levels could drop dangerously, and if it’s too high, it could turn fatal. To add to it, a COVID-infected lung is very delicate and has a dynamically changing status. This is where patient safety plays a huge role.

Dr. Sanjay Pathare, Medical Director along with Team ICU gratefully receiving two Noccarc V310 ventilators from Nocca Robotics team

Development & Testing

The speed with which the team developed this technology was incredible, but then came the next challenge of testing and validating this technology. After all, a patient’s life would be on the line and this ventilator would be the bridge between life and death. As a mentor, I oversaw every step of the process. Right from the concepts of fundamentals and functionality to conducting countless studies and endurance rests —every step was crucial. It successfully passed all stringent electrical safety, performance and calibration tests. Now, the most important aspect was having the ventilator tested in a clinical setting to ensure patient safety. During the 28-day study at our ICU, our team monitored the machine round-the-clock. In fact, there was a point of time when our fellow, Dr. Nipun Gupta volunteered to administer the ventilator on himself. We were quick to notice that the device enabled him to breathe comfortably for several hours. Thereafter, it was also tested on a couple of patients with critical lung infections making it clinically validated.

Dr. Prachee Sathe explains the working of the ventilator 

Award

Sure, it’s been a journey of grit and perseverance. Three months of this collaborative work resulted in the development of the Noccarc V310, an ICU ventilator that emerged victorious amongst 1500 entries in the #Innovate2BeatCOVID Challenge. This ventilator project emerged as India’s top 3 innovative ‘Ventilators and Other Respiratory Solutions’ and was awarded.  It was indeed a moment of pride for us to see our efforts come to fruition! I am also honoured that Nocca Robotics donated two ventilators to our institute. This gesture by Nocca Robotics will help us in the taking on the enormous challenge of ever increasing influx of coronavirus patients.

Nikhil Kurule, CEO, Nocca Robotics hands over Letter of Appreciation along with two ventilators to Dr. Prachee Sathe and team at ICU, Ruby Hall Clinic

Key features of Noccarc V310 ventilator

The Noccarc V310 is a turbine-based ventilator which consists of all modes required by doctors. In addition to being a state-of-the-art ICU ventilator for complex respiratory failure, it has some of the most unique features including the HFNC (high-flow nasal cannula), BiPAP (bilevel positive airway pressure) and CPAP (continuous positive airway pressure) modes. This machine has PRVC (pressure-regulated volume control) mode as well apart from offering both volume and pressure control. The most unique feature of this ventilator is that it comes with a UV chamber. When a virus-infected patient on a ventilator breathes out, he exhales air filled with virus loads, making it hazardous for all of us. The UV filter chamber kills the virus making it a safer environment.

Appreciation

Letter of Appreciation from Nocca Robotics

At a time when many indigenous ventilators are being rejected due to lack of clinical validation and feasibility, the fact that our team has been part of a project that has seen the light of the day is indeed heartwarming. As a doctor, it makes me beam with pride that we managed to create synergy between our desire to provide wholehearted care in times of crisis along with fostering the spirit of local innovation - that too, when we are managing the onslaught of the COVID crisis. As a human being, it gives me hope that there will indeed be a brighter COVID-free tomorrow.

Letter of Appreciation from IIT Kanpur

Gratitude

My sincere gratitude to Nocca Robotics and IIT Kanpur for the opportunity to be part of this project and the faith they reposed in us. I would like to specifically thank the following :

• Dr. Amitabh Bandopadhyay, KENT Entrepreneurship & Innovation Chair Professor, IIT Kanpur
• Dr. Abhay Karandikar, Director, IIT Kanpur
• Mr. Rakesh Bhargava, Former Chairman, FK Oncology Ltd.
• Mr. Nikhil Kurule, Co-founder & CEO, Nocca Robotics Pvt. Ltd.
• Mr. Tushar Agarwal, Sr. Product Manager, Nocca Robotics Pvt. Ltd.
• Ms. Aditi Kumar, Technical & Operations Head, Bioprograms SIIC, IIT Kanpur
• Dr. Tanima Baronia, Sr. Consultant in-charge, ICU, Ruby Hall Clinic
• Dr. Sandhya Zambare, Intensivist, ICU, Ruby Hall Clinic
• Dr. Arun Kumar P, Jr. Consultant, ICU, Ruby Hall Clinic
• Dr T R Jadhav , ICU senior consultant 
• Dr. Nipun Gupta, Fellow DNB Critical Care, ICU, Ruby Hall Clinic
• Brother Dinesh Divakar, Brother in-charge, ICU Ruby Hall Clinic
• Sister Urmila Nalawade, Sister in-charge, ICU, Ruby Hall Clinic
• Mr. Mahesh Bhosale, Biomedical Engineer, Ruby Hall Clinic
• Mr. Bomi Bhote, CEO, Ruby Hall Clinic
• Dr. Purvez Grant, Managing Trustee, Ruby Hall Clinic

Ruby Hall Clinic, Pune