Dr. Geoff Maksym of THORASYS at the European Respiratory Society (ERS) Annual Congress in Vienna.

In 2004, Dr. Geoff Maksym received a Legacy Research Grant from the Lung Association of Nova Scotia to conduct a study related to his work on Airwave Oscillometry™. Airwave Oscillometry is a method for measuring lung function without the patient effort that is needed in a spirometry test. “The idea began in 2003″, said Dr. Maksym, “It took us a couple tries to get this down into a device that is like a spirometer but we’ve had great reception at conferences so far.”

“It’s like a spirometer, where patients inhale their total lung capacity and then are asked to exhale as hard and as fast as they can, but much easier for the patient,” explains Dr. Maksym. “The spirometer technique works very well for people who can do the maneuver but for people who can’t, such as young children or elderly patients, it’s easier if we can create a technique where they don’t have to blow the air through.” So Dr. Maksym and his team set about to create such a device. The outcome was the tremoFlo™ C-100. “This device is essentially a little mesh screen in a tube that the patients breathe through,” explained Dr. Maksym. “The mesh screen moves back and forth, creating small pressure waves, like small puffs of air that go into the lungs, and it basically measures how hard it is for those puffs of air to move in and out of the lungs. The more pressure it takes to move a small volume of air into the lungs, the more narrow your airways are.”

In 2006, and again in 2010, Dr. Maksym would receive two more Legacy Research Grants for his ongoing work in lung health. Dr. Maksym credits these grants with helping him collect data and supporting his research in Airwave Oscillometry. “These grants get you started,” he said. “They’re like establishment grants. And those are very important, especially for the new researchers or for the more established researchers who are doing something in a new direction for which they don’t have preliminary data. The support we receive from the lung Association has been very helpful.”

In September 2012, Dr. Maksym, and his team at THORASYS Thoracic Medical Systems Inc., brought the tremoFlo C-100 to the European Respiratory Society (ERS) Annual Congress in Vienna (see photo).

“The Lung Association started us and helped us along the way and eventually it led to quite a bigger investment through ACOA,” said Dr. Maksym. “These grants don’t always lead to bigger things but I think without them it would be really hard for some of the lung researchers in Nova Scotia to make as big a difference nationally as they do.”

We are pleased to announce that THORASYS Thoracic Medical Systems Inc. (THORASYS) has received an investment of $500,000 (Canadian Funds) under the Business Development Program (BDP) from the Atlantic Canada Opportunities Agency (ACOA). The funds will be used to help THORASYS with the final steps required to bring the tremoFlo™ Airwave Oscillometry System (AOS)™ to market in the next twelve months.

Public Announcement

The official announcement took place Wednesday, September 12th, at the Dalhousie University Life Sciences Research Centre located near the Innovacorp offices. Dr. Thomas Schuessler, President and CEO of THORASYS, accepted the award on behalf of the THORASYS team and thanked ACOA and the Government of Canada for their support through the BDP and other programs. The ACOA funding “will be used towards a variety of go-to-market activities, including regulatory approval, marketing activities and launch preparations”, Schuessler said, “as well as to build THORASYS’ distribution network”.

The funding announcement came just days after the European Respiratory Society (ERS) Congress in Vienna, Austria, where the tremoFlo was introduced for the first time on European soil and received an enthusiastic response. Potential distributors, clinicians and global key opinion leaders coming by the THORASYS booth were impressed by the tremoFlo’s form factor, portability, ease of use, and the minimum effort and cooperation required from the patient when compared to Spirometry.

Congratulations to DeNovaMed

We would like to take this opportunity to also congratulate Halifax-based DeNovaMed, who received similar funding for their ground-breaking work towards developing treatments for drug-resistant infectious diseases.

For media coverage of the ACOA announcement, refer to The Chronicle Herald and to the AllNovaScotia.com website (subscribers only). A news release from the Government of Canada is also available on the ACOA site.

The entire Thorasys team would like to thank everyone who stopped by our booth at the recent European Respiratory Society Congress in Vienna, Austria. This was the first time we showed the tremoFlo™ on European soil, and we received an enthusiastic response!

Strong Attendance

From the moment the exhibit hall opened, we were exited to see a strong, steady flow of visitors from all over the world at our booth. Due to the large volume of visitors, it may take us a little bit of extra time to work through all our leads. However, we assure you that we are working hard to follow up with you and answer your questions with the shortest possible delays. Thank you for your patience and understanding! In the meantime, keep reading this blog for more up-to-date information about Airwave Oscillometry, Thorasys and the tremoFlo.

We’ll be located at booth B.103 in Hall B.                           
Sun, Sept. 2 – Tue, Sept. 4 – 9 am to 5 pm
Wed, Sept. 5 – 9 am to 12 pm

On behalf of our entire team, I would like to thank all attendees of the recent 2012 International Conference of the American Thoracic Society (ATS) who took the time to stop by our booth and take a look at the brand new tremoFlo™ C-100 Airwave Oscillometry System (AOS).

Introducing Airwave Oscillometry

As we went into the show, we were excited to present the tremoFlo C-100 AOS to the public for the first time. The display of our earlier prototypes had already received good feedback last year, but the C-100′s new portable form factor, ergonomic shape and straightforward software user interface produced very positive responses from researchers and clinicians alike.
 

New Thorasys Website

We would like to invite you to visit and bookmark our revised website at www.thorasys.com that went live concurrently with the start of the ATS exhibit. The product information on this site will be incrementally updated and extended over the coming weeks and months.

VAR & Hetergoneity

For several years now, the VAR technique has been a subject of interest for THROASYS’ Chief Scientific Advisor, Dr. Geoff Maksym, who heads the Biomedical Engineering Department at Dalhousie University in Halifax. In their most recent publication on this topic recently published in the Journal of Applied Physiology(1), Leary et al. further investigated this technique by mathematically modeling the stochastic and spatial heterogeneity in a human airway tree in order to develop a better understanding of the mechanisms that cause temporal variations in respiratory system resistance.

The authors used a multi-branch airway tree model to explore how variation in airway diameter is related to changes in airflow in the lung that are known to occur in asthma. They found that variation in airway resistance was explained not only by fluctuations in airway diameters that might occur with fluctuations in airway smooth muscle activity, but was also sensitive to changes in average airway constriction and the presence of ventilation defects, both of which are also increased in asthma. These findings provide new mechanisms and improve our understanding of why variation in airway resistance is increased in asthma.

Congratulations to Ph.D. students Del Leary and Swati Bhatawadekar for this excellent contribution.

Next Steps

At the recent Annual Biomedical Engineering Society meeting that took place in Hartford, Connecticut from October 13-15, 2011, the authors presented further research on this topic(2-5) carried out in collaboration with colleagues from Harvard University in Boston, Massachusetts and Western University in London, Ontario. Some of these studies feature measurement of airway reactance in asthmatics while others included the use of hyper-polarized gases to image the distribution of ventilation in patients with COPD.

We wish the authors best of luck and look forward to this work appearing in full-length manuscripts.

1. Del Leary, Swati A. Bhatawadekar, Grace Parraga, and Geoffrey N. Maksym, “Modeling Stochastic and Spatial Heterogeneity in a Human Airway Tree to Determine Variation in Respiratory System Resistance J Appl Physiol; http://jap.physiology.org/content/early/2011/10/11/japplphysiol.00633.2011.abstract.

2. D. Leary, A. Braune, T. Winkler, and G. Maksym. Modeling and Quantifying Heterogeneity of Airway Narrowing and the Contribution to Lung Mechanics. Platform presentation.

3. D. Leary, G. Parraga, and G. Maksym. Image-guided Stochastic Modeling of the Lung – Influence of Patchy Ventilation on Impedance Variability in Asthma. Platform presentation.

4. S. A. Bhatawadekar, P. Hernandez, C. McParland, S. Fulton, and G. N. Maksym, Bronchodilatory Induced Changes in Airway Reactance and Its Variation in Asthma.

5. A. Braune, D. Leary, G. N. Maksym, and T. Winkler, Effect of Symmetric vs. Asymmetric Tree Geometry and Airway Size on the Emergence of Ventilation Defects.

Watch for the cough…

One of the interesting things that this clip shows is what it’s like for many patients to take a spirometry exam. If you watch the very start of the clip, you may notice two things. First, the lady taking the test doesn’t look very comfortable after she has performed the manoeuvre and blown into the spirometer. Second, you can clearly see that the spirometry test triggers a cough response in this patient. Any RT will happily tell you that this is a common occurrence that can severely interfere with performing the manoeuvre. Obtaining three valid consecutive spirometry manoeuvres in a patient like this may prove to be quite a challenge, without any fault on behalf of the patient or the technician.

The starting sequence of this clip therefore illustrates quite nicely what many experts have said for years: although spirometry is considered quite useful when it is performed well, it also has many shortcomings and limitations, especially for those patients that would benefit the most from accurate and reliable lung function assessment.

Forced Oscillations

The Forced Oscillation Technique (FOT) is still in its infancy compared to decades-old spirometry. Because a patient simply breathes quietly through an FOT device such as our tremoFlo, though, the FOT has the potential to provide a better alternative to measure lung function – especially in patients like Eileen Anderson who need it the most.

¹Andrea S Gershon, Laura Warner, Paul Cascagnette, J Charles Victor, Teresa To. Lifetime risk of developing chronic obstructive pulmonary disease: a longitudinal population study. The Lancet, Vol. 378 (9795): 991-996, September 2011.

The International Conference of the American Thoracic Society (ATS) recently took place in Denver, Colorado, attracting an estimated 12,000 clinicians and scientists from the fields of respiratory, critical care and sleep medicine. For the first time in our corporate history, Thorasys was represented in the ATS exhibit hall to publicly present a pre-production prototype of our tremoFlo Oscillation Spirometer at a major international conference. We received a lot of visitors to our booth, and we would like to thank all of those who stopped by for this strong and enthusiastic response!

Outside the exhibit hall, we were also happy to see that the Forced Oscillation Technique (FOT) continues to show strong momentum, with a continuously increasing number of studies and presentations using this technique. With many of these studies employing large and/or “home-made” FOT devices, the need for a portable commercial FOT device like the tremoFlo was more evident than ever.  

As we continue to push towards the commercial release of the tremoFlo, we look forward to seeing you again at the European Respiratory Society (ERS) meeting in Amsterdam in September, and at ATS 2012 in San Francisco. In the meantime, don’t hesitate to write a comment on this blog or send us your questions at email hidden; JavaScript is required.

Thorasys Thoracic Medical Systems is an innovative medical device start-up located in Halifax, Nova Scotia, Canada. Our activities focus on the development of the tremoFlo, a novel medical device for the diagnosis and monitoring of respiratory diseases such as Asthma and COPD. The tremoFlo is scheduled to reach the market in 2012.

The tremoFlo is a small, portable device that uses the Forced Oscillation Technique (FOT) to provide accurate measurements of airway resistance and reactance. The tremoFlo does not require patient effort or cooperation and can hence be used comfortably by a wide range of paediatric, adult and elderly subjects, including mobility impaired patients and those who are unable to perform a voluntary manoeuvre. The tremoFlo can potentially replace so-called “spirometers” that require patient effort and cooperation to assess lung function.

The tremoFlo is currently being field tested at several sites throughout North America, and field testing in Europe is expected to start soon. This blog will provide regular updates about the tremoFlo development as we prepare for commercial release in several jurisdictions in the first half of 2012.