Study the past if you would divine the future – Confucius.
The Exovent team of engineers, doctors, and enablers are 100% behind the extremely important World Pneumonia Day. This special day was started by the Stop Pneumonia Initiative in 2009 to raise awareness about pneumonia, which is the worlds biggest infectious killer of children and adults, claiming the life of a child every 50 seconds and yet has been consistently overlooked when global action has been urgently required for decades. COVID-19 pneumonia and its associated sequelae are already adding millions to these yearly death tolls but the massive effort to control the pandemic must be used as an opportunity to reduce all deaths from respiratory illnesses, especially in women and children.
Action on climate control matters is required now and in the same manner action on pneumonia is required now! It is estimated that around 6 million children alone will die from pneumonia over the next decade, in addition to double that number of adults.
With the UN Climate Change conference, COP 26, in Glasgow fresh in our minds, it is an excellent moment to consider respiratory health, pollution and climate control by the world community. Everyone in the health sciences knows that “Prevention is better than cure”. Tackling air pollution, the leading risk factor for death from pneumonia across all ages is of upmost importance. As with so much disease the majority of deaths are concentrated in the low and middle income countries of the world but acute exacerbation of chronic obstructive pulmonary disease is a relentlessly increasing problem in wealthy countries as a result of cigarette smoking, obesity and polluting fuels.
It will take many years to bring these environmental problems under control and in the meantime the world needs improved treatment for pneumonia, where antibiotics are unfortunately only part of the answer. As the COVID-19 pandemic has shown viruses are a huge cause of pneumonia. Bacteria which cause pneumonia are increasingly resistant to current antibiotics. The COVID-19 pandemic has also revealed a woeful lack of oxygen supplies and cost-effective respiratory support devices in more than 100 of the poorer countries and also, the wealthier ones. The gross disparity between wealthy and poor countries to provide treatment for pneumonia has been even more starkly displayed. High quality intensive care unit facilities are unavailable or minimal in more than 2/3 of the world’s countries and modern positive pressure ventilators are extremely costly. Even when these are available they require sufficient highly qualified doctors and nurses to use them to care for patients.
Our dedicated Exovent team of doctors, senior engineers and enablers from all areas of life, have looked for inspiration from pandemics of the past and have come up with a remarkable new negative pressure respiratory support device for the future.
Paralytic polio during the 19th and 20th century led to the death of millions of children and young adults when their respiratory muscles were involved, but the introduction of negative pressure ‘iron lung’ ventilators (NPV) saved many thousands of patients with poliomyelitis and also pneumonia. Throughout most of the 19th century and the first half of the 20th century, negative pressure devices were most commonly used to help people breathe when they became seriously ill. Doctors moved from negative to positive pressure ventilation in the 1950s, largely because of the shortage of heavy and bulky iron lung devices, nursing issues and the development of smaller positive pressure devices.
However, positive pressure was not physiologically superior. A common misconception amongst the present generation of doctors and nurses, is that this form of breathing support was only useful for the well-known polio epidemics. In fact, some centres have continued to use, research and modernise negative pressure devices.
Both scientific and clinical evidence suggest that a modern negative pressure device with an ultra- lightweight cabinet jus over the chest and abdomen will provide an effective non-invasive ventilatory alternative to CPAP9,10. Importantly this may also be able to prevent escalation of the patient to intubation and paralysis and mechanical positive pressure ventilation in an Intensive Care Unit. Exovent will be used in conscious patients, who are then able to cough, talk, eat and drink whilst being ventilated. Negative pressure ventilation simulates natural lung movements, and does not reduce the hearts performance which can occur with positive pressure ventilation.
The ease of manufacture, use of readily available parts, low cost and easier nursing and medical management, including the prone position, are important further considerations of particular relevance to low- and middle-income countries.
We have studied the past to divine the future and produced an effective low-cost device for low and middle income countries where Exovent can easily be manufactured, maintained, repaired and used by doctors and nursing staff without an Intensive Care Unit, as well as the wealthy countries which have been being overwhelmed by COVID-19 pneumonia.
Further information on Pneumonia can be found at: