The software update to flexiware version 8.0 is required to communicate with and instruct the Baseunit to perform these new maneuvers whilst a model is on the machine. Significantly, the software update is also required to facilitate the interpretation of complex flow, volume, and pressure outputs collected by the flexiVent from inside and outside the model during these maneuvers in order to calculate the key new PFT/FEV outputs. PFT/FEV measurements cannot be performed on existing Scireq® flexiVent lung function equipment without these two key purchases. CIs Horvat and Kim have an ongoing relationship with the Sales and Techsupport teams at Scireq® and, due to this relationship, we have been afforded the opportunity to gain access to this cutting-edge equipment/software extension prior to its public release outside of beta testing (so we have a technological advantage over research competitors) for a very competitive price. Expanding the capabilities of our existing Scireq® flexiVent equipment, which is currently not capable of performing PFT/FEV measurements, is a more economical and strategically beneficial option than buying a whole new system from BUXCO/DSI that can only perform PFT/FEV measurements. Having a flexiVent apparatus with the PFT/FEV extension will provide the ability to perform in-depth respiratory mechanics, including classic outcomes (resistance and compliance) with unique tissue partitioning (central airways vs parenchymal tissues), structural assessment (pressure volume [PV] loops), flow limitation outcomes (FEV), and PFT (total lung capacity [TLC], residual volume [RV], functional residual capacity [FRC]) on one piece of equipment. No other single piece of equipment on the market can collect all these data. Furthermore, there are no other pieces of equipment available that can expand/enhance the capabilities of our existing lung function systems to perform PFT/FEV maneuvers from other manufacturers. Importantly the latest technique (proprietary) for generating PFT/FEV data using the Scireq® system are more reliable than other systems.
Historically, FRC is extracted during PFT/FEV testing from the PV curve at a pressure of 0cmH2O, which can be inaccurate depending on the disease state of the lung or gender of the subject. Scireq’s latest system runs a standard PV loop immediately before the degassing procedure in the PFT/FEV maneuver, which determines the volume difference between the PV Loop and the PFT/FEV maneuver. Therefore, the Scireq® system calculates FRC using the same method across subjects, but can also measure lung volumes at a unique pressure where the elastic recoil of the lungs truly matches the elastic recoil of the chest wall providing greater accuracy of actual lung volume characteristics.
State-of-the-art lung function testing in models of lung disease has and will continue to play a fundamental role in the success of the strong translational respiratory research programmes at HMRI that are administered by VIVA-affiliated researchers. We use several pieces of equipment to carry out lung function testing. The Scireq® flexiVent apparatus is critical for measuring airways hyper-reactivity (AHR) and deep tissue-specific changes in lung function that are characteristic of the structural and functional tissue changes observed in a number of pulmonary diseases, including chronic obstructive pulmonary disease (COPD)/emphysema, idiopathic pulmonary disease, cystic fibrosis, lung infections and especially severe, steroid-resistant asthma. The BUXCO/DSI forced maneuvers (FM) machine conducts pulmonary function testing/forced expiratory volume (PFT/FEV) measurements on models that are akin to the lung function testing performed in respiratory clinics on patients with respiratory disease. Significantly, this ability to measure PFT/FEV is especially important for our translational work as it provides the strongest link between our models of lung disease and clinical disease. Unfortunately, our BUXCO/DSI FM machine is over 10 years old and, whilst it is still operational, it is beginning to fail on a regular basis, is increasingly difficult to service in a timely manner, and is becoming obsolete and will be replaced by improved versions of PFT/FEV equipment available from Scireq® and DSI.
We are now in the position where researchers that rely on PFT/FEV-measuring equipment are having their career progression negatively affected by the unreliable equipment in our laboratory. The cumulative impact of ever-increasing FM machine failures and the turnaround time required for servicing results in researchers (mostly PhD students, ECRs/MCRs) not being able to collect valuable PFT/FEV data from their models in a reliable manner during endpoint days. Furthermore, we only have one FM machine that is capable of performing PFT/FEV measurements. Our current machine is used by >12 ECRs/MCRs and >10 PhD/Honours students. This is placing a significant bottle-neck on the research output of VIVA. Therefore, we are applying for funding through the MRSP Special Infrastructure Scheme to purchase new equipment (Baseunit controller for PFT/FEV extension) and software (flexiware version 8.0) from Scireq® that can be added to one of our existing Scireq® flexiVent lung function machines. This critical hardware extension and associated software update will provide the capability to collect PFT/FEV data from the Scireq® flexiVent in addition to the other lung function outputs that can be measured using this apparatus. This will not only increase reliability and throughput (will mean that we have a second machine for collecting PFT/FEV data) but it represents an improvement on other pieces of equipment and techniques available for measuring PFT/FEV. The Scireq® PFT/FEV system distinguishes itself from other competitors on the market by calculating functional residual capacity (FRC) in a novel, more robust way. Also by adding the PFT/FEV extension to the flexiVent, Scireq® offers a complete assessment of the lungs with one system.
Dr Jay Horvat, Dr Chantal Donovan, Dr Richard Kim, Dr Shakti Shulka, Dr Prema Nair, Dr Md Atiqur Rahman