Med-Tech Innovation Materials Innovation Award Winner 2020 - Spyras

Spyras are this year’s Med-Tech Innovation Materials Innovation Award winner. The company has developed a disposable, paper-based wearable device for continuous real-time breathing analysis in hospitals.

The device is designed to automatically alert clinicians to early signs of patient deterioration. Med-Tech Innovation News spoke to George Winfield, CEO and founder, to get his reaction to the company's success.

First of all, congratulations on winning the award, how do you feel?

We were thrilled with the news. To have been firstly listed amongst the calibre of other businesses listed that some would described nothing short than some of the most innovative businesses in the materials space, but to have be chosen as the overall winner, we are nothing short of delighted.

For a start-up, such as Spyras, to have been awarded an international accolade such as the Materials Innovation Award means that we are on the right track to truly bringing innovation into this world. We could not be more excited to do exactly that.

What made you opt for paper-based sensors?

Stemming from the research of Dr Firat Güder and the research being conducted from the lab. It was the intrinsic nature of exploring new ways to observe respiratory monitoring, a vital sign that has such restrictive methods to be able to analyse crucial and life saving parameters. Rather than being confined to be using existing methods to measure breathing rates such as piezo-electric changes of chest expansion of the impedance conductivity of the chest, what if we could use a hidden parameter?

Using the moisture content of breath and the changes of inhalation and exhalation allowed for a highly accurate way to derive similar parameters of measuring breathing pattern to the golden standard of respiratory monitoring, Capnography. What limited this approach in the outset was the dependant on electronics. Electronic waste, especially in the medical space where single use, understandably, is now the mainstream to move away from any infection risk, causes some deterrent to create a humidity sensor based on electrical waste. Paper was the answer. The paper you are reading this article from is absorbing water from the environment without you noticing. By exploiting this hygroscopic nature of paper and the changes of moisture difference of exhaled and inhaled breath paired with a conductive electrode pairing on the papers surface to measure the conductivity changes of this cyclic change, gave an affordable, highly accurate and disposable sensor. The use of a paper sensor for respiratory monitoring was something not previously seen before.

Does your material of choice mean the monitoring aspect of the wearable works differently to something we may be more accustomed to?

The advantages of using a paper-based sensor are that it is highly accurate in respiratory monitoring, affordable and can be disposed without increasing the plastic burden of the environment and be recycled, as paper can. Currently in hospitals, we are accustomed to seeing disposable plastic elements for nearly everything: respiratory tubes, plastic syringes, ECG or EMG electrodes as all coated in plastic. Spyras’s paper sensor brings a major advancement into greener sensing technologies and per-patient monitoring devices not just in medical but sports and other wearable devices. The real advantage Spyras sees in using the monitoring method of humidity of breath and paper is the type of data gathered. In an ECG reading the sinus rhythm is split into the PQRST intervals and as such using the intervals and segments between these areas can give insights into the patient’s health. What if we could pick points in the respiratory breathing cycle and gather possible insights to such an individually characterised vital sign such as breathing?

Rather than only the period of breathing rate per minute being obtained, Spyras can breakdown the respiratory cycle to take into account the inhalation and exhalation periods with ratios, depth and even going into the depths of calculating the users breathing exertion. Just how hard has the patient had to work to take that breath? Breaking down the cyclic action of breathing can provide what is normal a normal breath for the patient vs what could be abnormal. Capturing this dynamic data point creates the best predictive element in forecasting a possible deteriorating patient and giving ample opportunity to intervene.

With that in mind, how does the device alert clinicians when it comes to patient deterioration?

It learns what is currently normal for the patients breathing, breaks down the respiratory parameters and give more insight that previously available so that for once, respiratory information can be confidently acted upon. Nothing more.

One clinical example where an increase in respiratory rate frequency is a vital marker for patient deterioration is sepsis. Currently this vital sign is visually estimated, by looking at the rising and falling of the chest and this is only done on the length observation wards. If they see an abnormal increase in the rate, it is documented alongside the other vital sign scores in the Early Warning Score (EWS) system. Opportunities not to accurately report respiratory rate in the EWS score can lead to the patient be missed in these manual observation rounds and with conditions such as sepsis, every hour is vital.

This device can be adjusted to several user cases as the clinicians see best, attach the sensor to oxygen masks for patients where hypercapnia could be a concern, to the nose of a patient who may only need general monitoring (useful for sleep and apnoea monitoring also) or also into nasal cannula of the patient. Allowing the clinician to tailor the device as they see best for the patient was crucial in maintaining a device that fits into the clinical pathway and does not add to it. The sensor itself fits onto the Queen’s head of a 5p coin (pictured), offering a discreet monitoring solution. The data is then sent to the nearby nursing station where the custom dashboards fits into the existing system and designed to allow for third party solutions to add to the data set, so cardiac monitoring can hand-in-hand with Spyras and vice versa.

It’s paper based, but can you shed light on other materials that may be used in constructing the device?

We don’t want to give too much away but for this particular sensor it’s the hygroscopic nature of paper. As you read this article and I hope you are still reading, the pages are adsorbing and de-adsorbing water from the environment. This has led to the substrate and therefore the sensor having the unique ability in being able to self-calibrate to the external environmental conditions. The cyclic action of this principle allows for the sensors to continuously monitor breathing over a sustained period of use without a risk of reaching saturation.

We have not yet touched on the ability to derive air volume and gases on breath when the sensors are characterised to do so. Non-invasive breath analysis through gas and Volatile Organic Compounds (VOCs) holds real promise in the use of hygroscopic sensors for real time, quantitative analysis and therefore diagnosis of health conditions through breath. No need for needles. No need for specialist or trainer personnel to take it. No need for special storage conditions. Print the sensors, characterise them and take the breath sample.

Do you any future plans regarding this device? Whether that be branching into other areas of further development?

As a respiratory start-up formed in 2018, it was presumed that Brexit could be the real challenge with a transitioning regulatory framework for the EU intwined into this period of uncertainty. Entering 2020, an entirely new player has entered the healthcare scene and risk to businesses, COVID-19. It has certainly been interesting to see this pandemic changed the cultural norm and working practice to adopt new technologies and practices to cope. Virtual clinical sessions now take place at the convenience of the patient and clinician, without the need of travel. Mask adoption is now widely adopted and looks set to remain in an aid to reduce transmission and protect the vulnerable and at risk.

Spyras was naturally inquisitive to try something, what if we could print the sensors directly into masks? The filters of these masks provide a great way to incorporate a humidity sensor into these environments where humidity is prevalent to track respiratory parameters. Using the disposable nature of the sensors here also complements the use case in this context greatly. Not only providing user information about their respiratory health in real time from their phones but the air they breathe. Pollution levels on their commutes, pollen levels, how efficient their filter will remain when breathing in these changes in weather conditions and air quality that could cause their mask to be rendered useless. The user can also be sure to conduct breathing exercises and even play games using their breathing pattern to ensure a little bit of fun is breathed into that morning commute.

Anything else you’d like to add? You can include a short victory speech here, too, if you’d like to!

We would like to thank the judging team on believing what Spyras is developing and creating. For those still reading and wish to follow our journey or read more on our website www.spyras.com and out social channels @BreatheSpyras.