Bioengineers Develop Innovative Respiratory-Assist Device as Alternative to Ventilator

photo of innovative respiratory device

Photo: The late Craig Smallwood, S’07, PhD’18 bioengineering, in March 2020 with the first five prototypes of his expiratory positive airway pressure (EPAP) device. These prototype devices are currently being used in Korle Bu Teaching Hospital in Ghana.

For the past couple of years, Lee Makowski, professor and chair of the Department of Bioengineering, has been partnering with government officials in Ghana, as well as Biomedical Engineering faculty at the University of Ghana, to improve health care.

“From the hospitals in its largest cities to a network of rural clinics, there is a lack of both trained health care professionals and biomedical engineering innovation in Ghana,” explains Makowski. “By bringing Northeastern and University of Ghana bioengineering students together, as well as holding technical workshops there, we have been seeking to kick-start innovative new medical technologies and advance the state of health care.”

A need turns to a crisis

While this effort has been ongoing, it transformed into a critical situation with the sudden, unprecedented global spread of COVID-19 in the first two months of 2020. “Ghana has a population of 2.4 million and about 200 ventilators,” Makowski says. “Since there was a worldwide shortage of ventilators, there was no opportunity to purchase new ones. I wondered if we could come up with a Plan B. Clearly, we needed to do something quickly to avert disaster. I reached out to my colleagues to try to find the respiratory therapy expertise we needed.”

Enter Craig Smallwood. Smallwood had earned a B.S. in cardiopulmonary science, with a concentration in respiratory therapy, from Northeastern in 2007 ― then began working as a respiratory therapist in the ICU at Boston Children’s Hospital. Thanks to his innovative and inquisitive spirit, he was appointed the hospital’s coordinator of clinical respiratory research in 2010. In 2018, Smallwood earned his PhD in bioengineering at Northeastern, and in 2019 he became an assistant professor of anesthesia at Harvard Medical School.

“Craig was the perfect person to help answer the crisis in Ghana,” notes Makowski. “In fact, he had already been thinking about the problem when I contacted him in early March. He knew that a low-tech device was needed which would strengthen patients’ lungs and prevent the need for a ventilator. The low-tech aspect was critical, because health care workers in Africa have little formal training. The device also had to be cost-effective to produce, since African hospitals have little funding.”

A heroic effort ― and an unexpected loss

craig smallwood portrait

Craig Smallwood, PhD’18, Bioengineering

Working tirelessly together over the next month, Smallwood and Makowski developed a low-cost expiratory positive airway pressure (EPAP) device that would use the energy of expelling breath to create pressure in patients’ lungs, increasing their function and capacity. After developing and testing prototypes, the team shipped five prototype EPAP devices to Ghana on March 30.

Smallwood and Makowski had been in close contact about the EPAP project every day, so Makowski was surprised when he didn’t hear from Smallwood on the morning of April 10, when the researchers had a Zoom call scheduled with their partners in Ghana. Then Makowski learned the devastating news: Smallwood had died unexpectedly of a stroke the night before. Smallwood left behind his wife Erika, also a Northeastern alum, and their children, five-year-old Sadie and one-year-old Max.

“Craig’s death is an enormous loss for everyone who knew him,” says Makowski. “But it is also an enormous loss for the health care industry, and doctors and patients around the world. Right up until the end, he was focused on solving urgent medical problems and working for the greater good. He was truly a unique, caring individual who will never be forgotten. He accomplished so much in 36 years.”

A legacy that will live on

Today, two patients at Korle Bu Teaching Hospital in Accra, Ghana, have used the EPAP system ― now named the Smallwood Unit ― to recover from respiratory illnesses without the need for a ventilator. Makowski believes this is just the beginning of Smallwood’s lasting impact.

“The next phase of the plan is to manufacture 100 Smallwood Units and ship them to hospitals in Ghana, Liberia, Niger and other African nations where COVID-19 numbers are increasing,” states Makowski. “They have the potential to make a critical difference in the lives of many patients who might not have a chance otherwise.”

Smallwood’s legacy of research innovation will also be carried forward by a new fellowship that will be awarded annually by Dräger, a manufacturer of respiratory equipment. Each year, a researcher will receive $50,000 in funding as part of the Craig D. Smallwood Early Investigator Fellowship, administered through the American Respiratory Care Foundation (ARCF).

Related Faculty: Lee Makowski

Related Departments:Bioengineering