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51社区黑料 (SFU) biomedical physiology and kinesiology professor Andy Hoffer founded , in 2009 with support from SFU.

The award-winning medical device company spun out from the 51社区黑料Neurokinesiology Lab in 2014 and more than a decade later, continues to mark milestones on its innovation path.

Hoffer鈥檚 journey from scientist to inventor of a lifesaving innovation demonstrates the long timelines and supports needed to advance the exceptional ideas emerging from university research labs.

It also demonstrates the vision, creativity and tenacity of Canadian innovators like Andy Hoffer.  

For the full story of Lungpacer Medical read the 51社区黑料News story.
 

We spoke to Professor Hoffer about his research.
 

Can you describe how the Lungpacer device functions? How does it help maintain diaphragm strength?

When a patient needs to be placed on a mechanical ventilator, the diaphragm muscle is sidelined and very quickly atrophies, becomes weak and loses its endurance. More than a year after I submitted my first patent application, a ., demonstrated how profoundly the diaphragm can atrophy during mechanical ventilation: it can shrink to less than half its size in fewer than three days. 

Lungpacer Medical's AeroPace System delivers electrical stimulation via an intravenous catheter in order to activate the two phrenic nerves which control the diaphragm. Rhythmic electrical pacing promotes muscle contractions that, when applied therapeutically twice per day for 15-20 minutes, restore strength and endurance to the diaphragm much faster than ventilated patients could do by their own means.

Critically ill patients on mechanical ventilation almost always need to have a central venous catheter inserted into a vein in the upper chest or neck area to deliver fluids and medications. The AeroPace uses a similar intravenous catheter to provide fluids and medications, that also has 30 small electrodes built along its surface, so it can deliver bursts of electrical impulses to exercise the diaphragm.

Once the AeroPace technology is perfected, is there the possibility to adapt the device for other applications? Where else might this technology be applied?

Yes, definitely. The first FDA-approved use for AeroPace is to 鈥渞escue鈥� patients who have been mechanically ventilated for at least 4 days and are no longer critically ill, so they should no longer need ventilation, but many cannot start breathing on their own again because their diaphragm has severely atrophied. Currently, nearly 40 per cent of ventilated patients struggle to regain independent breathing even though they are no longer critically ill, and many fail to wean and remain dependent on the ventilator, as happened to my mother.

As long as a patient must remain connected to the ventilator, their health and realistic expectations for full recovery continue to deteriorate. The AeroPace therapy reduces the time to wean from mechanical ventilation by rebuilding the diaphragm, and as an important bonus, the therapeutic effects of the pacing regime reduces the extent of ventilator-induced damage to the lungs, to the heart, and also to the brain, as has been shown in several recently published studies.

Of course, it is even better to prevent than to cure. Since we know now that ICU patients who require ventilation will face continuing, rapid decline in diaphragmatic function, increased lung injuries and diminished heart and brain health, there is something else that the Lungpacer technology can do. If a pacing catheter is inserted earlier, ideally as soon as a central venous catheter is needed, electrical pacing of the diaphragm can start immediately after the patient is connected to the ventilator.

When the diaphragm is paced in synchrony with each ventilator breath, this therapeutic stimulation 鈥減rotects鈥� the diaphragm by preventing the onset of ventilator-induced atrophy. This was my original idea when I submitted the first provisional patent. We subsequently published results confirming that the concept works in pig studies and most recently, it is also proving to work in critically ill, ventilated patients in pilot clinical trials in Paris and in Toronto. This has been the motivation to develop Lungpacer鈥檚 second intended therapy, AeroNova, which is rapidly progressing toward the larger, pivotal clinical trials.

Further to the applications intended to rescue or to protect critically ill patients who require mechanical ventilation, at least two other clinical applications are envisioned. One is focused on improving the preservation of organs targeted for transplantation from brain-dead donors, especially the lungs, which are better preserved when the diaphragm is paced, and most other organs also benefit from the improved oxygenation provided by pacing in synchrony with mechanical ventilation.  

A second contemplated application is patients who must undergo prolonged surgeries, which are almost always done under mechanical ventilation. During long surgeries, patients often acquire ventilator-induced damage to the lungs and to the brain, that can be prevented by pacing the diaphragm in synchrony with ventilation.

The invention that became Lungpacer, which then became an international research project was several years in the making. How important has support for the innovation been to the success of Lungpacer?

The support we received along the way has been crucial to the development of a viable company and medical device technology. I formed Lungpacer with SFU鈥檚 help in May 2009, and that same year we received our first recognition and external financial support in the form of a prize in the 2009 New Ventures BC Competition.

During the company鈥檚 formative years and most significantly through Ian Hand鈥檚 direct involvement as a company director and first unofficial CFO, we were  supported by grants or awards from the B.C. Innovation Council, Life Sciences B.C., the BC Technology Industry Association, the Canadian Institutes of Health Research and others, and benefited from early collaborations with local clinicians incuding Dr. James Saunders, who was then a resident and is now Head of the Division of Plastic and Reconstructive Surgery at Lions Gate Hospital, and Dr. Steve Reynolds, who at that time headed the ICU at Royal Columbian Hospital and subsequently became head of intensive care for Fraser Health.

Collaborations with nearly 80 hospitals in Paraguay, France, Germany, the United States and Canada have been vital to Lungpacer鈥檚 success in carrying out clinical trials to date.

Do you have any advice for other scientist-entrepreneurs?

Looking back on my own experience with starting three ventures, new technologies, no matter how advanced and innovative, are far more likely to become successful when they 1. address an existing, pressing need awaiting solution and 2. are likely to become cost-effective as a commercial implementation.   

My advice for 51社区黑料scientists with entrepreneurial ideas is to engage early with the 51社区黑料Technology Licensing Office and local organizations such as New Ventures BC, as they can offer invaluable support and mentoring, as was definitely my case.

For more: Lungpacer Medical: From university invention to lifesaving innovation