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USU Student Medical Innovations Group Develops Novel Respiratory Distress Treatment

Three people in goggles and masks work with the bubble BPAP.

By Dillon Parker

The Medical Innovations Interest Group (MI2G), a student-led group at the Uniformed Services University of the Health Sciences (USU) devoted to empowering medical students to think creatively, has developed a novel solution to treat babies with respiratory distress in austere environments where access to lifesaving medical equipment is not always available. 

The bubble BPAP - which looks like a modified water can
The finished device shows how a portable
battery can be used to power the simple
electronics in the field. The water
generates a back pressure for the patient
by allowing air to bubble through the
water, hence the name bubble BPAP.
(Courtesy photo)
One current low-resource respiratory treatment, known as “bubble CPAP” (continuous positive airway pressure), was shown to have a number of shortcomings. Army pediatrician Lt. Col. (Dr.) David Ayer, from Madigan Army Medical Center, found that issues with the bubble CPAP can lead to dangerous carbon dioxide build-up in babies with severe respiratory distress. USU students in MI2G sought to find a solution.  

“The problem with bubble CPAP is that when you try to treat severe respiratory distress and increase the air pressure coming into the baby's lungs, the babies are so small that you reach a point where they can no longer exhale out CO2,” said Army 2nd Lt. Bradley Pierce, USU School of Medicine student and co-founder of MI2G. “The challenge was to turn “bubble CPAP” into “bubble BPAP” (bilevel positive airway pressure) which uses a high pressure during inhalation and a low pressure during exhalation to improve oxygenation and ventilation over CPAP alone.” 

MI2G collaborated with cadets in the U.S. Military Academy at West Point Pre-medical Society to meet this challenge and develop a simple, economical innovation that can be used in low-resource environments. 

“We tried to answer the question: How can you take the bubble CPAP and turn it into a bubble BPAP in the simplest way possible?” said Pierce. “We chose to do that by using a simple servo motor to raise and lower the respiratory tube used in bubble CPAP. With $10 worth of electronics, just a battery and a motor, you can turn the bubble CPAP into the bubble BPAP and greatly increase these capabilities.”

Pierce and his colleagues have received several accolades for this innovation, including the Emma L. Bockman Award and Outstanding Poster at USU research days. A second year cadet under Pierce’s mentorship at West Point also received a $12,000 scholarship from the Strive Foundation to develop the concept further, which she hopes to use to travel to Africa to see how it would be used firsthand.

The success of the project highlights the importance of groups like MI2G that focus on creativity and innovative thinking in medicine. The group started in 2018 when Pierce and co-founder Army 2nd Lt. Josephine Pucci, a USU School of Medicine classmate, decided to create a network of military providers and medical students who can help push military technology forward.

Two students at a table with a water can that will be modified to create the bubble BPAP.
U.S. Army West Point Cadets Alicyn Grete and Alex
Burgess cut open a water can to create the bubble BPAP
device at West Point. (Courtesy photo)
“My goal has always been to go into military medicine and I wanted to be able to redesign the advanced equipment you find in hospitals so that it can be deployed more easily around the world,” said Pierce. “Founding MI2G was a way to not only connect with military providers that have already developed their own technology and learn from them but also a way to connect with our peers and find people with similar interests.  And then it just grew from there.”

MI2G now has more than 100 students and faculty involved and is becoming a bridge not only between students and faculty but between USU medical students and pre-medical cadets at West Point. 

“An opportunity exists through MI2G to increase collaboration between USU medical students and West Point cadets to support student innovation and help solve military-relevant medical challenges,” said Pierce. “It's a natural fit to be able to support and mentor the cadets. I think we've shown the benefits of it and the potential for future collaboration as well.”

While the cadets benefit from the mentorship MI2G provides, MI2G and the military medical community as a whole gain an incredible asset through this collaboration with a diverse group of cadets.

“Innovation in medicine is increasingly becoming an interdisciplinary effort and it's necessary for students to connect with others with a diverse knowledge base,” said Pierce. “The founding goal of MI2G is to be able to build an infrastructure where, if somebody sees a problem, they can come back to the group and launch their own device or innovation with the support of MI2G. This collaboration helps us add new voices to the network and push military medicine forward in an exciting way.”