How hospitals are tapping into 'endless potential' of 3D printing to combat COVID-19

The COVID-19 pandemic has spurred a new use for 3D printing in hospitals – addressing equipment shortages by creating PPE and device components needed for makeshift ventilators.

With COVID-19 cases accelerating across the country, many hospitals and health systems are facing equipment and bed shortages in their intensive care units. One solution to this has been 3D printing; some health systems such as USC Keck Medicine, Massachusetts General Hospital and Northwell Health have tapped 3D printers to create PPE and devices as a precaution. Whereas others, such as Stony Brook University in New York City are distributing 3D printed PPE to their clinicians on the frontlines of the pandemic. 

Stony Brook University started 3D printing face shields and distributing them to its clinicians nearly three weeks ago, Charlie McMahon, interim senior vice president and enterprise CIO, told Becker's Hospital Review. Since then, the hospital has printed more than 1,000 face shields through its iCREATE lab, a program within its IT division focused on technological innovation.

The project has been a collective effort from a surprising number of organizations that have been eager to help, according to Mr. McMahon.

Using its own 3D printing equipment, Stony Brook University was able to print about 40 face shields per day. The hospital was able to triple daily production to 120 face shields after numerous organizations including Estee Lauder and the County Library Association asked if they could assist by using their own 3D printers. 

Stony Brook University isn't the only hospital receiving outside support to increase 3D printing capacity. At Los Angeles-based Keck Medicine of USC, an estimated 500 people have signed on to help 3D print facemasks for clinicians and healthcare workers treating COVID-19 patients. With a development time of about five hours to print a single mask, the health system now has about 1,000 printed masks ready for use in case supplies run out, said Darryl Hwang, PhD, assistant research radiology professor at Keck Medicine of USC.

Dr. Hwang has been spearheading the hospital's efforts to produce the 3D-printed masks as a precaution. The 3D-printed PPE serves as a back up for Keck Medicine of USC as well as nearby hospitals in the event of a shortage. 

"We're not trying to replace N95 masks," Dr. Hwang said. "We're not trying to say that our masks are better than N95 at all. We're saying we don't want to be faced with the CDC nightmare scenario of running out of PPE and having to use bandanas and scarves."

USC's architecture school has been a large support system for the hospital's project, sourcing more than 150 3D printers from its student population to help print the face masks. And while Keck Medicine's 3D printing efforts are purely precautionary at this point, the hospital is collaborating with its infection prevention group and stakeholders that would be using the 3D-printed PPE to ensure the products' coverage is enough to protect its healthcare workers.

When Keck Medicine of USC initially began 3D printing PPE in late March, the hospital used a printing model from a maker group that sources for Massachusetts General Hospital in Boston. Like Keck Medicine of USC, MGH has not begun using 3D printed facemasks and face shields but instead is creating a stockpile in case of a shortage.

MGH has developed several different prototypes for facemasks and face shields, but while 3D printing "is great for prototyping," the technology is not as effective for producing products at scale, according to Marc Succi, MD, fellow in Emergency Radiology at MGH and Founder and Executive Director of MESH Incubator, the hospital's prototyping and entrepreneurship laboratory. 

In addition to scale, another challenge associated with 3D printing PPE is the debate surrounding reuse and sterilization, Dr. Succi said. Consumer and hobbyist materials used to create 3D-printed products may be more permeable than traditional materials, potentially resulting in environments that viruses or bacteria can reside in, effectively avoiding sterilization by cleaners such as Clorox cloth wipes.

"In addition to issues with scaling 3D printing, now you're faced with the problem of having to test varying sterilization methods on all the different plastics you can print to ensure that you can reuse the 3D printed mask," Dr. Succi said. "Often you may want to reuse it because it takes so long to print and it's somewhat more expensive."

To sanitize its 3D printed PPE, Keck Medicine of USC is exploring a hydrogen peroxide wipe down process as well as ultraviolet light technology.

Aside from PPE, 3D printing can be used to also address ventilator and testing supply shortages during the COVID-19 pandemic. New York City-based Northwell Health recently developed a protocol to transform a bi-level positive airway pressure machine, which maintains consistent breathing at night for people with sleep apnea or congestive heart failure, into a functional ventilator. The health system is also 3D printing COVID-19 test kit nasal swabs.

Northwell Health 3D printed an adapter that can convert a noninvasive Philips Respironics v60 BiPAP machine into a ventilator. The health system's 3D Design and Innovation Lab has eight Formlab 3D printers, which, if up and running 24 hours per day, would be able to print 150 adapters for the machines, said Todd Goldstein, PhD, director of 3D design and innovation at Northwell Health.

"The adapter allows one end of the circuit, or the physical tubes that go in and out of the BiPAP machines, to be connected to an endotracheal tube to then intubate a patient, add an oxygen line, as well as add two [high efficiency particulate air] filters that are used to stop the aerosolizing of the virus," he said.

Northwell Health is sharing its 3D printing processes to help other health institution that are looking to address potential ventilator shortages. Dr. Goldstein said he and his team are working with some 3D printing companies and private industry stakeholders so it can share its 3D printing protocol with other organizations that reach out. 

"We are all in this together and it's heartwarming to see so much collaboration — and cross industry collaboration — to combat this fatal virus," he said. "From PPE, to machine conversion to oxygen tubes and nasal swabs, the potential for the 3D printing industry to help is endless and I look forward to doing my small part in this war against COVID-19."

Keck Medicine, Massachusetts General Hospital and Stony Brook University are all sharing their 3D printing models and processes with outside organizations as well, offering support to those who reach out and some publishing resources to their individual websites.

The wide-scale collaboration has been a "nice, unexpected side effect" to the attention 3D printing initiatives have captured, Mr. McMahon said.

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