1. Team Members: Sara Karle Ashley Matsick Michele Lorenz Emily Maslonkowski Client: Dr. Mihai Teodorescu Advisor: Prof. Mitch Tyler

2. Intellectual Property Statement All information provided by individuals or Design Project Groups during this or subsequent presentations is the property of the researchers presenting this information. In addition, any information provided herein may include results sponsored by and provided to a member company of the Biomedical Engineering Student Design Consortium (SDC). –Anyone to whom this information is disclosed: –1) Agrees to use this information solely for purposes related to this review; –2) Agrees not to use this information for any other purpose unless given written approval in advance by the Project Group, the Client / SDC, and the Advisor. –3) Agrees to keep this information in confidence until the relevant parties listed in Part (2) above have evaluated and secured any applicable intellectual property rights in this information. –4) Continued attendance at this presentation constitutes compliance with this agreement.

3. Problem Statement Background Motivation Design Constraints Mechanical Design Circuit Design Future Work

4. Create a device: –for in-home use –to provide pulsed delivery of inhaled steroids –in line with commercial CPAP machines –using the ventilation circuit and flow generated by the CPAP

5. Obstructive Sleep Apnea: Cessation of breathing during sleep despite effort to breathe - Most common in obese adults - Muscles relax, causing airway to collapse - Side effect range: drowsiness to heart attack - Treated with Continuous Positive Airway Pressure (ASAA 2007) unobstructedobstructed http://www.cpap.com

6. Continuous Positive Airway Pressure (CPAP) –Delivers steady pressure of room air Patients generally require a pressure b/t 6-14 cm H 2 O –Humidifier often integrated –Mask types can vary CPAP machine by Respironics http://remstarpro2.respironics.com/ NasalFull face Hybrid http://www.directhomemedical.com

7. Metered-dose Inhalers (MDIs): - Used to treat respiratory illnesses - Combine active ingredients with propellant -Require priming + moderate shaking before actuation -Upright actuation required -Most effective drug delivery occurs during inhalation (Dhand 2004) http://www.solvay-fluor.com

8. Patients with obstructive sleep apnea also commonly have asthma Asthma symptoms worsen in early morning Chronic asthma symptoms treated with inhaled steroids Delivery with CPAP forces drug deeper into lungs Need for fast-acting inhaler during the day may be minimized by treatment at night (Teodorescu 2007)

9. Agitate MDI to mix drug and propellant Depress inhaler to deliver drug Detect breathing pattern to coordinate drug delivery with inhalation Interface with existing CPAP ventilation circuit Size, weight, and noise levels appropriate for in-home use

10. Design alternatives (cams): –Multi-ridge cam (vibration + actuation in single rotation) –Double spring + single cam (holding + actuation bumps) – Double cam design (Fall 2003/Spring 2004) Pros: Single motor, 1 rotation Cons: Large cam, inflexible Pros: Single motor, 1 rotation Cons: Spring dampening, need for complete testing http://en.wikipedia.org/wiki/Cam

11. Adapted from previous BME 400 design group 2 rotating cams & 2 motors –1 each for shaking, actuation Pros: - Shaking, actuation can be finely controlled - Easy/inexpensive control system Cons: - Weight, size of 2 motors (limits location of integration) http://homepages.cae.wisc.edu/ ~bme200/mdi/secure/ Testing performed (Fall ’03/Spring ‘04): - Effect of shaking amplitude/frequency on MDI dose delivery Demonstrated that automatic shaking approximated manual shaking

12. LabVIEW timer Vibration cam Thermistor Actuation cam Setpoint: 4:00 am Action: power on    Setpoint: “X” rotations Action: power off , power on  Setpoint: T° threshold Action: power off  power on    Setpoint: 1 rotation Action: power off  http://sine.ni.com Detecting inhalation Thermocouple RTD Thermistor lower precision than inexpensive fast response less sensitive than

13. Machine cams and construct mechanical shaker/actuator Test drug delivery with UV spectroscopy Interface device with existing CPAP ventilation circuit Write LabVIEW program: detect inhalation, power to motors Human subjects testing

14. Dhand, R. “Basic Techniques for Aerosol Delivery During Mechanical Ventilation.” Respiratory Care, 49.6 (2004): 611-622. Quinn K, Lam Y, Vanderpool R. “Automated MDI Vibrational Device,” Madison, WI: University of Wisconsin-Madison (2004): 44. “Sleep Apnea Information,” American Sleep Apnea Association. 3 Oct 2007 Teodorescu, Mihaela. Personal Interview. 13 Sept 2007 Teodorescu, Mihai. Personal Interview. 13 Sept 2007