3D printing for health: new solutions to the challenge of Covid-19 in Catalonia

The main advantages of 3D printing or additive manufacturing compared to other manufacturing processes is that it allows rapid geometric validation of designs, as well as the production of short series of parts. Additive manufacturing is seen as a complementary method to plastic injection, which has a much higher production capacity at low cost.

The application of 3D printing in the health sector has been oriented, until now, to the personalized manufacture of prosthetics and implants for orthodontics, orthopedics and traumatology. The lack of sanitary material, due to the global health crisis caused by Covid 19, has prompted a series of initiatives in the health sector through additive manufacturing as an alternative method of local production of sanitary equipment and devices to cope with the breakdown of stocks.

The lack of sanitary material, due to the global health crisis caused by Covid 19, has prompted a series of initiatives in the health sector through additive manufacturing as an alternative method of local production of sanitary equipment and devices to cope with the breakdown of stocks.

In this way, different networks of companies, entrepreneurs and volunteers grouped under the name of “Makers” have organized themselves collaboratively and altruistically to avoid the possible collapse of health resources and to respond to a series of vital and urgent needs. identified.

Covid 19 is highly contagious (R0 = 2- 2.5 seconds WHO) (1) and is transmitted during close unprotected contacts (2); in some people it attacks the lungs, specifically the cells of their alveoli, and can cause from the sensation of suffocation to pneumonia and respiratory failure that makes it necessary to use respirators as ventilatory support (3).

Next, some of the most relevant identified manufacturing projects by 3D printing of sanitary equipment and devices to deal with the pandemic and lack of equipment will be mentioned below. You can find other interesting initiatives made or not by 3D printing in the report generated by AQuAS (4).

LEITAT 1, industrial 3D respirator

Given the shortage of respirators, the Leitat 1 – a respirator built in Catalonia that has obtained the authorization of the Spanish Agency for Medicines and Health Products (AEMPS) and can be used in the framework of a clinical trial in Catalonia – has arrived at the time suitable for the high demand for these devices since the traditional market could not meet the needs. Leitat 1 has been designed by Magí Galindo, scientific and technical director of IAM 3DHub a Leitat. And clinically validated by Dr. Lluís Blanch, director of innovation and research at the Parc Taulí hospital. This respirator is partially manufactured using 3D printing, and functions as a simple, field vent that allows one person to intubate for three to four days. This respirator is the result of the alliance between the Free Zone Consortium (CZFB), HP and Leitat (Tecnio) together with CatSalut, through the Consorci Sanitari de Terrassa (CST) and the Hospital Parc Taulí de Sabadell together with the Hospital Clínic from Barcelona -the latter two have carried out the tests- and in collaboration with other entities and companies. (5) (6) (7)

SPARE PARTS AND AIR CONNECTIONS of the 3D laboratory of the Institute of Research and Innovation I3PT Parc Taulí

The Parc Taulí 3D laboratory, with Dr. Ferran Fillat in charge, has led a manufacturing initiative through 3D printing of spare parts and airway connections. This initiative has approximately 600 collaborators, notably the Official College of Physicians of Barcelona (COMB), the Official College of Industrial Engineers in Catalonia (EIC) and the collaborating companies grouped together on the 3dcovid19 platform. Dr. Fillat’s team clinically validates the designed and 3D printed parts that are made available in a catalog with the technical design and printing parameters as well as the material requirements (8). The EIC coordinates the production of the companies according to the needs that the hospitals have expressed and the COMB is in charge of the distribution according to the orders. Although initially the manufacture of parts was done entirely in 3D printing, some models in the catalog have been able to inject themselves into plastic, exponentially increasing production. By mid-April, this initiative had manufactured 105,000 consumables for ICU respirators, nasal goggles, and valves for assisted breathing, of which 57% were manufactured by injection (9).

Protective Screens, Other Gadgets and Maker Culture

The Maker culture is an extension of the DIY (Do it Yourself) culture that promotes the idea that all people are capable of carrying out any task instead of having to hire a specialist to do it (10). The “coronavirus Makers”, the “Tierras del Ebro” makers and the “Covid Warriors” are some of the self-organized volunteer communities in Catalonia that dedicate efforts to alleviate the impact of Covid in the health sector through 3D printing. These self-organizing communities with great collective intelligence thanks to the power that the proper use of social networks gives: while creating visor designs, and other gadgets for health personnel, others manufacture them on their 3D printers, others clean and There are also those who offer their transport to bring the material to hospitals and nursing homes where the material serves to save lives (11).

In Catalonia, these communities have focused mainly on the manufacture by means of 3D of sanitary equipment not considered as PPE or sanitary product such as: the protective screens or visors, the openers -where the involvement of CIM_UPC stands out- and the ear-protectors . The different printable designs in Catalonia by the maker community have been validated by healthcare professionals in the country. In addition, these communities have coordinated with hospitals and / or territorial health services to respond to demand in an orderly manner. In early April, CoronavirusMakers had manufactured and delivered 27,000 screens. The 3dcovid19.org platform has also contributed to the production of protective screens (14,000 face shields made by injection and some 6,000 made by 3D printing).

In Catalonia, these communities have focused mainly on the manufacture by means of 3D of sanitary equipment not considered as PPE or sanitary product such as: the protective screens or visors, the openers -where the involvement of CIM_UPC stands out- and the ear-protectors .

The Catalan ecosystem in 3D printing

Catalonia along with the center of Europe, the United States and Japan are the four world hubs that lead the knowledge and the 3D printing industry.

2018 data from the Catalan 3D hub (13):

• 90: Number of companies offering 3D printing services
• 90%: Percentage of Small and Medium Enterprises
• € 239m: Total billing
• 1,118 Workers employed in 3D printing
• The health sector is one of the main focuses of interest

The World’s Leading 3D Printing Development Hubs

The 3D printing sector has achieved considerable growth in recent years and during these months this potential has been put at the service of health centers to try to alleviate the lack of medical supplies. Companies, entities in the health sector, research centers, as well as volunteers from the maker community have organized to produce large quantities of sanitary equipment and devices.

The versatility and advantages of additive manufacturing that are being demonstrated during these months in the health sector, is opening doors to the diversification of products from companies in the sector and asks whether it should promote the incorporation of 3D printing laboratories in Catalan hospitals.

It will be worth taking advantage of this socio-technological push for when this crisis passes, we can have a new activity sector, more powerful and reinforced together with the rest of the emerging fields of the new economy

References:

• 1. WHO. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Internet]. 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
• 2. WHO. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations [Internet]. 2020. Available from: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
• 3. Catalunya A de SP de. Preguntes i respostes sobre la COVID-19 [Internet]. 2020 [cited 2020 Apr 27]. Available from: http://salutpublica.gencat.cat/ca/detalls/Article/Nou-Coronavirus-2019-nCoV
• 4. AQuAS. Ventiladores mecánicos y otros dispositivos sanitarios para la crisis de la COVID-19 : iniciativas , regulación y recomendaciones [Internet]. 2020. Available from: http://aquas.gencat.cat/web/.content/minisite/aquas/publicacions/2020/ventiladores_mecanicos_COVID19_AQuAS_abril2020es.pdf
• 5. Polo J. Coronavirus: La Zona Franca fabricará 100 respiradores diarios con impresoras 3D. La Vanguardia [Internet]. 2020 Mar 22; Available from: https://www.lavanguardia.com/vida/20200322/4830789695/respirador-3d-coronavirus-consorci-de-la-zona-franca.html
• 6. CatRadio. Manel Balcells: “El respirador Leitat 1 sortirà en qüestió de dies” [Internet]. CCMA. 2020. Available from: https://www.ccma.cat/catradio/alacarta/catalunya-nit/salut-el-respirador-leitat-1-sortira-en-questio-de-dies/audio/1067915/
• 7. Jiménez-Botías M. Un respirador “made in Catalonia” comenzará a producirse este lunes. El Periódico [Internet]. 2020 Mar 22; Available from: https://www.elperiodico.com/es/economia/20200322/un-respirador-made-in-catalonia-comenzara-distribucion-hospitales-7900250
• 8. Hospital U. Parc Taulí. Catálogo de piezas [Internet]. 2020. Available from: http://www.tauli.cat/es/institut/plataformes-i-serveis/laboratori-3d/covid-3d/cataleg/
• 9. Rigol J. Comunicació interna del coordinador de la producció.
• 10. Juan Manuel García. Coronavirus Makers: innovación social y cooperación tecnológica contra la Covid-19. La Vanguardia [Internet]. 2020 Apr 20; Available from: https://www.lavanguardia.com/tecnologia/20200418/48544501897/coronavirus-makers-mascarillas-impresoras-3d.html
• 11. Fernández J. Coronavirus makers: el virus bueno. La opinión Coruña [Internet]. 2020 Apr 6; Available from: https://www.laopinioncoruna.es/sociedad/2020/04/06/coronavirus-makers-virus-bueno/1492299.html
• 12. Bel J. Comunicació interna del coordinador dels “makers Terres de l’Ebre”. 2020.
• 13. Investment CT&. 3D Printing in Catalonia. 2018.