After witnessing a need for noninvasive breathing support in preterm neonatal care, first-year medical students at the Western University of Health Sciences (WesternU) in Pomona, California, decided to use 3D printing to create prototypes of CPAP (continuous positive airway pressure) masks for babies born before the 37-week-term.
Delivered through a small mask that fits snugly over a baby’s nose, CPAP masks are considered one of the least invasive forms of giving breathing support to premature newborns with respiratory distress and related diseases. Typically used for babies who are breathing well enough on their own that they don’t need more invasive mechanical ventilation like a ventilator, CPAP treatment delivers constant air pressure into a baby’s nose, which helps the air sacs in their lungs stay open and helps prevent apnea.
While 3D printed CPAP masks are already an emerging field in pediatric medicine, investigation assessing the application and protocol for integrating 3D printed CPAP masks into preterm neonatal care is limited, says WesternU. Other medical institutes agree. For example, researchers at the Mayo Clinic indicated earlier this year that limited sizes of CPAP masks contribute to “mal-fitting related complications and adverse outcomes” in a “fragile population.” The team has also been looking into techniques and procedures to create accurate 3D printed neonatal facial models, which, according to a research paper published in August 2022, were effective at decreasing surface pressure and mask strap pressure.
As part of WesternU’s project, the students first 3D scanned infant manikins to make 3D models that were then used to 3D print the CPAP mask prototypes. Next, a 3D digital model was rendered from the student scans, which will be used in developing the digital design prototype. When the design is complete, the CPAP prototype will be printed using a UV-cured flexible resin, helping to create a solid connection, thereby minimizing air leakage.
Led by Gary Wisser, educational 3D visualization specialist at WesternU’s Center for Excellence in Teaching & Learning (CETL), the project engaged students from the university’s iSquad center for innovation, a popular student group passionate about medical device ideation, biotechnology, and informatics. Wisser instructed the iSquad first-year medical students in scanning the tiny facial features of infant manikins, which will be used to generate an accurate 3D rendering.
“It’s always great to be able to create prototypes with students who are trying to develop solutions to problems they discover in the real world,” said Wisser, who spent the last 15 years creating several 3D educational animations to help explain complex medical ideas. “If I can help the student turn a problem into a solution at such an early stage in their career, I think they can look at hurdles as opportunities. Now, 3D scanning, printing, and visualizations can be added to the toolkits they’ll use to serve future patients.”
CPAP therapy with selective surfactant administration is the current preferred strategy initiated in preterm neonates who are at risk for neonatal respiratory distress. However, nasal trauma is a frequent complication in very low birth weight preterm infants using CPAP masks with nasal prongs for extended periods.
According to Natasha Holden, one of the students involved in the project and a first-year med student at WesternU’s College of Osteopathic Medicine of the Pacific (COMP), in some infants of low birth weight, CPAP therapy is delivered using soft, neonatal-sized nasal masks suitable for direct-skin and facial contact with newborns. However, in this population, poorly fitted nasal masks can cause difficulties and irritation over prolonged periods. Holden highlights that doctors and researchers hope 3D scanning and printing technologies will help improve the options for children, especially for young infants.
Fellow student Jane Park commented that she expects to prove that 3D printing can provide personalized solutions to neonatology, mainly thanks to the technology’s feasibility, cost-effectiveness, and scalability.
“Hopefully, by establishing a manageable protocol, our work can be applied to demographics such as pediatrics and adult sleep medicine, where CPAP mask is the standard treatment, but difficult to achieve compliance. With medicine becoming more personalized, 3D printing can be the future of medicine,” indicated Park, doctor of osteopathic medicine (D.O.) Student Class of 2025.
By providing innovative ways to facilitate learning, research, and solutions to the medical community, CETL provides opportunities for WesternU students and doctors to enhance medical innovations. For example, experts like Wisser are passionate about 3D printing, which he frequently uses in research for student learning or to help prototype and test new devices in CETL’s 3D print lab.
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