An implantable ventilator augments inspiration in an in vivo porcine model

Abstract Severe diaphragm dysfunction can lead to respiratory failure, requiring permanent mechanical ventilation. Permanent tethering to a mechanical ventilator via a patient’s mouth or tracheostomy can interfere with quality of life and autonomy by hindering activities like speech and swallowing. We present a diaphragm assist system that intervenes internally at the diaphragm as opposed to the mouth. By implanting contractile, soft robotic actuators above the diaphragm to push downwards and augment diaphragm motion during inspiration, this diaphragm assist system functions as an implantable ventilator. We demonstrate the proof-of-concept feasibility of this system to augment physiological metrics of ventilation in an in vivo porcine model of varied respiratory insufficiency. Synchronized actuation of the assist system with native respiratory effort augmented the tidal volume by up to a 100 mL increase and was capable of improving minute ventilation into a normal range. The diaphragm assist system has the potential to provide a new therapeutic ventilation option that aims to restore respiratory performance without sacrificing quality of life.