OxyJet CPAP

Respiratory diseases are the leading causes of death in upper-middle-income countries. With approximately 450 million people worldwide affected by pneumonia, resulting in 2.49 million deaths globally and 0.57 million deaths in South Asia alone, the impact is profound. Asthma affects around 262 million individuals globally, leading to 0.46 million deaths worldwide and 0.057 million deaths in South Asia. Furthermore, respiratory infections as a whole contribute to 3.7 million deaths globally, with 1.1 million deaths occurring in South Asia, highlighting the urgent need for ICU facilities and high end respiratory support devices. Even in the United States, every year, over 5 million patients are hospitalized in intensive care units (ICUs) for the purpose of intense or invasive monitoring, and respiratory insufficiency/failure with ventilator support is among the top five diagnoses for adult ICU admissions. Here in Bangladesh, the number of critical care beds per one lac population across the country is found to be only 1.70, and thirty eight of the total 64 districts have no critical care facility in the local hospitals. Moreover, the availability of medical devices in Bangladesh is limited and not well distributed. Healthcare centers in rural or suburban areas are not well equipped to treat respiratory diseases, one of the top diseases responsible for death, according to the Centers for Disease Control and Prevention (CDC). The death rate in Bangladesh for lung disease is 41.72/lac population and ranks 25th in the world. Another respiratory disease, COPD, is found to be prevalent ranging from 10.3% to 13.5%, among adults in Bangladesh. Hospital systems have a severe shortage of  intensive care units (ICU), sophisticated medical devices, a shortage of oxygen supply, and well-equipped ambulances. These get worse as patients in ward settings are moved directly to ICU if they are not maintained at a low flow of oxygen and require a higher facility. There is no intermediate state to bridge between the ward and ICU settings.

We have developed innovative, cost-effective, sustainable respiratory medical devices for achieving state-of-the-art respiratory healthcare facilities, especially in low-resource settings. Our product, ‘OxyJet CPAP', is thus an inexpensive, non-invasive, and portable positive pressure ventilator that is completely electricity-free. It is uniquely built using off-the-shelf components, making it inexpensive and readily producible. We can attach our device to the wall mounted center-line oxygen and also to existing/conventional medical oxygen cylinders with a flow meter that can deliver CPAP therapy to hypoxic patients using the jet-mixing principle of pressurized oxygen and room air. However, it can provide a high flow of oxygenated air up to 75 L/min (approx.), a positive end-expiratory pressure (PEEP) within 5–15 cmH2O, and a fraction of inspired oxygen (FiO2) of up to 100%. Therefore, our solution can transform low-flow oxygen supply systems such as oxygen cylinders and central oxygen lines into high-flow CPAP.

                           Figure: Full set-up of OxyJet CPAP Device

In low-resource-settings, general hospital wards cannot usually provide oxygen support exceeding 15 L/min. In this context, our solution, oxygen-supplemented Continuous Positive Airway Pressure (CPAP) can be an effective bridging therapy in general wards, reducing ICU admissions for hypoxic patients with ARDS, asthma & pneumonia patients, and patients with other respiratory distress. Cardiac arrest patients and sleep apnea patients also need a high flow of pressurized oxygen. Again, in all health care systems, along with ambulances, it can be implemented as it only requires oxygen supply and no electricity. Our solution will upgrade the general ward settings, strengthening the health care system from which around 464.5M chronic respiratory distress (CRD) can benefit.

We have successfully completed a four-phase randomized control trial at two reputable government hospitals in our country, Dhaka Medical College & Hospital and National Institute of Diseases of the Chest and Hospital (NIDCH), enrolling fifty patients. The government's Directorate General of Drug Administration (DGDA) has granted limited approval (NOC) for our device based on the trial's interim results. Additionally, we have got a letter of support from the Ministry of Health's Directorate General of Health Services (DGHS) Non-Communicable Disease Control (NCDC) programme, which allows us to use our device in all district hospitals in Bangladesh. Thus far, we have effectively disseminated our solution to 15 reputable hospitals in Bangladesh, both government and private, as well as ambulances. 

As our technical partner, OxyJet Limited and Bangladesh University of Engineering and Technology (BUET) signed an agreement. Our team, which consists of twenty interdisciplinary people with backgrounds in data science, computational model analytics, public health, policy, regulation, medical and external affairs and innovation. However, we have close interactions with healthcare institutions and authorities.

We have completed our trial phase and are waiting for full fledge local approval. Our initial seed-stage investment has aided in safeguarding our intellectual property (US and Bangladeshi patents) and ensure the opportunities to build-up our own manufacturing plant in order to obtain approval and make it commercially available throughout the country. Additionally, a letter of support from the Ministry of Health's Directorate General of Health Services (DGHS) Non-Communicable Disease Control (NCDC) programme has advanced the approval process to a great extent. Currently, we are manufacturing our device via the additive manufacturing process, and over fifty patients across fifteen hospitals have benefited from our solution. We have already confirmed our injection mold design version with a third party manufacturing company for mass production with an ISO 13485 facility.

We are looking to gain networking opportunities with expert and impact-minded leaders, build collaboration and integration with the top market shareholders, and obtain mentorship from field experts. Also, we want to receive funding for further development and approvals and to establish our solution.

Our solution, the OxyJet CPAP device, stands out for its innovative approach to addressing respiratory care challenges in low-resource settings. Unlike traditional methods that rely on costly ICU admissions and limited oxygen supplies, our device transforms existing low-flow oxygen systems into high-flow CPAP without electricity only by using pressurized oxygen flow from the oxygen line, bridging the gap between ward and ICU treatment. This approach not only reduces the economic burden on patients and healthcare systems but also optimizes resource utilization and expands access to critical respiratory support beyond hospital walls.

By offering a cost-effective, versatile, and electricity-free solution, the OxyJet CPAP device has the potential to catalyze broader positive impacts in the healthcare space. It empowers healthcare providers in low-resource settings to deliver high-quality respiratory care to underserved populations, leading to improved patient outcomes and reduced mortality rates from respiratory diseases like pneumonia and asthma. Additionally, its compatibility with general ambulances enables safe transportation of patients over long distances, addressing gaps in emergency medical services.

The introduction of the OxyJet CPAP device could revolutionize the market landscape by shifting the focus from expensive ICU-centric treatments to more affordable and accessible ward-based solutions. This shift has the potential to disrupt traditional healthcare models, driving innovation and encouraging the development of similar cost-effective technologies for other medical conditions. Ultimately, the widespread adoption of our solution could lead to a more equitable and sustainable healthcare system, benefiting communities locally and globally.

Our solution, the OxyJet CPAP device, aims to have a direct impact on improving respiratory care for hypoxemic patients in low-resource settings by addressing several key challenges. Here's how our theory of change outlines the logical links between our activities, outputs, and outcomes:

1. Activity: Introducing the OxyJet CPAP Device

• We introduce the OxyJet CPAP device to hospitals and healthcare facilities in low-resource settings.

Output: Accessible and Cost-Effective Respiratory Support

• The OxyJet CPAP device transforms existing low-flow oxygen systems into high-flow CPAP, providing cost-effective respiratory support without the need for expensive ICU admissions.

• Healthcare providers receive comprehensive training on device usage, ensuring proper implementation and patient care.

Immediate Outcome: Reduced ICU Admissions and Patient Expenses

• By offering high-flow CPAP in general wards, we reduce the need for ICU admissions, alleviating strain on healthcare resources and reducing hospital costs.

• Patients experience lower out-of-pocket expenses for respiratory treatment, making healthcare more affordable and accessible.

Longer-Term Outcome: Improved Patient Outcomes and Healthcare system strengthening

• With timely and effective respiratory support provided by the OxyJet CPAP device, patients experience improved clinical outcomes, including reduced mortality rates and shorter hospital stays.

• Increased accessibility to respiratory care in low-resource settings strengthens the overall healthcare system, particularly for marginalized populations who may face barriers to accessing specialized medical facilities in general-ward .

Broader Positive Impacts: Catalyzing Innovation and Equity in Healthcare and Saving Energy

• The success of the OxyJet CPAP device in addressing respiratory care challenges inspires further innovation in cost-effective medical technologies, catalyzing positive change in healthcare delivery models.

• By promoting equity in healthcare access and outcomes, our solution contributes to broader efforts to address disparities in health outcomes and improve the well-being of communities locally and globally.

• Electricity-free modules inspire more innovation to save energy in this field, promoting clean and green energy.

Our theory of change is supported by evidence from clinical studies demonstrating the efficacy of the OxyJet CPAP device, as well as feedback from healthcare providers and patients who have benefited from its implementation. Through continuous monitoring and evaluation, we aim to refine and strengthen our approach, maximizing the positive impact of our solution on the problem of inadequate respiratory care in healthcare settings.

Impact Goals:

1. Reduced Mortality Rates: Our primary impact goal is to reduce mortality rates associated with respiratory diseases, particularly pneumonia and asthma and other hypoxemic patients, in low-resource settings like Bangladesh. We aim to significantly lower the number of deaths attributed to these conditions by providing timely and effective respiratory support through the OxyJet CPAP device.

2. Improved Healthcare Access: We seek to improve healthcare access for underserved populations by making respiratory care more accessible and affordable reducing out-of-pocket costs. Our goal is to ensure that hypoxemic patients in low-resource settings have access to high-quality respiratory support, regardless of their socioeconomic status or geographical location.

3. Measurement of Progress:

1. Mortality Rate Reduction:

• We track the number of deaths in the target regions before and after the introduction of the OxyJet CPAP device.

• Specific indicators include the percentage reduction in mortality rates for pneumonia and asthma over a specified period, compared to baseline data.

Healthcare Access Improvement:

• We measure the number of patients receiving respiratory support through the OxyJet CPAP device in low-resource settings.

• Indicators include the percentage increase in the utilization of the device among eligible patients and the expansion of its deployment to underserved areas.

Patient Outcomes:

• We monitor patient outcomes, including hospitalization duration, ICU admissions, and overall clinical improvement, among those treated with the OxyJet CPAP device.

• Indicators include the average length of hospital stay, the percentage reduction in ICU admissions related to respiratory conditions, and patient satisfaction surveys regarding the effectiveness and accessibility of respiratory care.

Equity in Healthcare Access:

• We assess the distribution of the OxyJet CPAP device across different socioeconomic groups and geographical regions to ensure equitable access.

• Indicators include the percentage increase in device deployment in marginalized communities and the reduction in healthcare disparities related to respiratory care.

By tracking these indicators and evaluating our progress against our impact goals, we aim to continually refine and optimize our approach to maximize the positive impact of the OxyJet CPAP device on respiratory care outcomes.

Our solution, OxyJet CPAP, works using the venturi principle. A dual flow meter (twin flowmeter) has been used where one of the ports can deliver 15 L/min flow (primary port) and the other can give 50 L/min flow (secondary port). The OxyJet flow generator is attached to the primary port to deliver 15 L/min flow, which creates a high velocity due to the venturi effect and pulls environmental air. This results in a high flow of (up to 75 L/min) oxygenated air mixed with air. We can control the %FiO2 in the flow through the secondary port of the flowmeter. Thus, we can control the percentage of oxygen in the flow.

Full-time Staff: 4 Persons

Part-time Staff: 2 Persons

Advisors: 14 Persons

We have been working since 2020. At that time, we started our research and established our low-cost and compact solution. Later on, in 2022, we formed our company.