Medical Therapeutic Equipment: Growth of Respiratory Care Devices
By Jenny Bieksha, Bishop & Associates Inc.

A vast assortment of equipment falls into the medical therapeutic market segment, and these devices are driving multiple applications and electronic interconnect opportunities. This market encompasses a broad range of equipment used in hospitals, as well as portable devices used in home healthcare, including defibrillators, infusion pumps, pacemakers, hearing aids, dialysis machines, and respirators.

The global respiratory care devices market has grown significantly over the past few years, and is expected to grow at a steady pace over the next five years. A rapidly aging population, rising rates of Chronic Obtrusive Pulmonary Diseases (COPD), technical advances in respiratory care devices, and tight budgets faced by healthcare institutions are the major factors influencing the market.

The U.S. market alone for respiratory equipment (including anesthesia and sleep management devices) is valued at more than $3.1 billion. The United States and Europe are market leaders. The global respiratory market is highly fragmented, with numerous local and international players. Companies from emerging economies are competing with multinational players, leading to downward pressure on device prices.

The emergence of home healthcare has opened new avenues for the respiratory care devices market, as smaller and portable devices come into play in non-medical settings. Currently, this segment accounts for about 40% of the end user market. The convenience and comfort possible in a home care environment, coupled with cost advantages, are the major factors driving the home healthcare market for respiratory care devices.

Positive Airway Pressure (PAP) devices command the largest share in the respiratory care therapeutic devices segment. The PAP device market is the largest segment and accounted for almost 58% of the total revenue generated in 2010. Technical advances such as portability and increased battery life are primarily influencing the growth of this market. The PAP device segment will continue to enjoy high growth and remain the largest segment in future.

A Glimpse at the Evolution of Respiratory Equipment
The evolution and growth of respiratory equipment has been significant. As with many applications in the electronics industry, the design concept for respirators originated with a military application. Forrest Bird is best known as the inventor of the first practical mass-produced medical respirator. During World War II, he served in the Army Air Corps and became a pilot. At that time, new designs in airplanes allowed for flight at higher altitudes; however, gear was needed that would allow pilots to breathe at a higher altitude. These experiences led Bird to develop Aircrew Breathing Regulators and anti “g” force devices.

His Bird® Mark 7 medical respirator, which came to be known as the Bird, succeeded. The small, green, box-like apparatus quickly became a common piece of equipment in hospitals around the world. In 1970, Bird introduced the Babybird respirator, which reduced infant mortality due to respirator problems from 70% to less than 10%. The V.I.P Bird Infant Pediatric System was introduced in 1992, specifically designed for the neonatal, infant, and pediatric patient population. The TBird Ventilator Series is the world’s first and only ventilator that can move with the patient from each clinical setting to the next without interruption.


The first modular pneumatic miniaturized device, the FLOWRATE controlled ventilator (Percussionator), was designed for the routine maintenance of any size patient. This became the Military Transporter Ventilator (TXP). The miniaturized universal TXP ventilator has proven to be a highly reliable mass casualty transport, as well as a routine ventilator for all patient populations. Further developments in 2007 led to the portable Home CARE HT Impulsator, which weighs less than 15 pounds.

Respiratory Care Equipment and Applications
Respiratory care equipment is used to examine, monitor, and treat respiratory ailments that may occur due to COPD, trauma, and other diseased conditions. Respiratory care equipment ranges from ventilators, nebulizers, and peak air flow meters. Medical ventilators, either portable, home care, or those used specifically in emergency rooms and intensive care units, are an important component to respiratory care.

Spirometers and peak air flow meters are essential in diagnostic work and provide respiratory care equipment that the patient may also be able to use to check their respiration. Nebulizers are often prescribed to treat a variety of respiratory conditions, including allergies and asthma.

A continuous positive airway pressure (CPAP) device is a type of respiratory ventilator used to keep a patient’s airway open. First developed for the treatment of sleep apnea, CPAP devices are now commonly indicated for patients with chronic heart failure, respiratory distress and arrest, and COPD. CPAP devices are also frequently used on premature infants in neonatal intensive care units.

Manufacturers are creating more compact machines, which use less room in already crowded operating rooms and other places where space is at a premium. An example of this equipment is the Palm Top Ventilators (PTVs), which are made for critical care. The ENVE ventilator by CareFusion is the size of a tissue box, and weighs approximately eight pounds. The new PTVs have four-hour swappable batteries. If a change of battery is needed, an internal one takes over so that respiratory therapy can continue without disruption. Many companies are working on the development of closed-loop ventilators that will monitor breathing and respond automatically if a problem occurs.

Noninvasive ventilation systems offer a low-cost alternate form of sub-acute therapy for patients. The integrated display screen uses real-time graphics in waveforms or bar scale format to provide enhanced monitoring for caregivers. Pressure support ventilation (PSV) — a process in which the ventilator automatically completes the breath in a spontaneously breathing patient — is a particularly noteworthy advancement in some modern-day anesthesia systems.

Changes in hospitals over the past few years have heightened the market requirement for ventilator connectivity. Patients that were once found in highly concentrated locations are now located all over the hospital. Online ventilator systems are becoming popular as hospitals centralize patient data. One ventilator on the market contains a web server that can display the ventilator’s settings, monitoring, and alarms on computers, hospital networks, or the Internet.

Whether for short-term treatment of acute respiratory problems or for long-term therapy to treat patients with chronic respiratory disorders, many of the same design concepts and components apply. Pressure sensors play an important role for respiration equipment by converting physical values such as airway pressure and flow into a differential signal. The accurate processing of these signals is life-critical. The air and oxygen flow sensors generate signals to help the microprocessor control the valves to deliver the desired inspiratory air and oxygen flows. The airway pressure sensor generates the feedback signal necessary for maintaining the desired positive end expiratory pressure (PEEP).

Some systems are equipped with compressed-gas tanks and backup batteries to provide ventilation in case of power failure or defective gas supplies. It is important that the battery management components accurately assess the energy levels to ensure safety and reliability. Typical features include:

• The front panel features the LCD display, the controls for setting up and operating the ventilator, LEDs to indicate the ventilator’s power source, ventilation on/off status, and alarm priority level.

• The back panel includes the O2 inlet port, which connects the ventilator to a low pressure oxygen source via an adaptor connected to the O2 inlet, RF/IF, USB key connection, RS-232, and a nurse call output connector (various connector sizes) and the AC power connection.

• Portable ventilators designed for longer operational ability utilize a lithium battery.

The effectiveness and reliability of healthcare devices and systems rely on the robust design, engineering, and performance of their underlying electronics. The form factor of medical devices, such as those used in portable and patient-wearable devices, continues to drive miniaturization of interconnects. Electronic interconnect opportunities will continue to grow with the various medical market segments, including home healthcare.

Jenny Bieksha Director, Renewable Energy, Medical, and Military, Bishop & Associates Inc. Jenny Bieksha joined Bishop & Associates in 2008 as its market segment director for the renewable energy, and the test, measurement, and instrumentation markets. She is currently a management consultant specializing in strategic business planning, with an emphasis on the development of program, market, and product plans. Bieksha has more than 20 years of experience in the electronics industry, with a background in market management, business development, channel sales, product management, and operations for ITT Corporation, Delphi Connection Systems, and Hughes Aircraft Company. Bieksha has a bachelor of science degree in marketing from the University of Wyoming, and also holds a certificate as a project management professional.