FDA OKs Lungpacer’s Diaphragmatic Pacing Therapy System for COVID-19 Patients

The U.S. Food and Drug Administration has issued Emergency Use Authorization (EUA) for the Lungpacer Medical’s novel Diaphragmatic Pacing Therapy System (DPTS) for immediate use in patients on invasive mechanical ventilators at high risk of weaning failure, including COVID-19 patients.
 
“We are thrilled to hear about the FDA’s decision to grant an EUA for the Lungpacer DPTS. Hospital resources around the world have been under significant strain during the COVID-19 pandemic and ICU beds and mechanical ventilators have been at peak demand. This novel therapy has the potential to wean patients earlier from the ventilator and free up resources during these difficult times. We are looking forward as an institution to start using this technology to help our patients during this pandemic,” noted Ali Ataya M.D., Assistant Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Florida Health, Gainesville. Dr. Ataya also recently co-authored the publication reporting the results of the RESCUE 1 trial, which demonstrated feasibility, and assessed initial safety and efficacy of the Lungpacer DPTS.¹
 
Lungpacer DPTS is the first minimally invasive, temporary, transvenous phrenic-stimulation system cleared through Emergency Use Authorization by the FDA. This non-surgical, non-implanted, diaphragm stimulation therapy is delivered via a central venous catheter (CVC), similar to central lines currently placed in mechanically ventilated ICU patients. The unique central line is used to deliver both fluids and medications, while also incorporating the capability to activate the diaphragm muscle via transvenous phrenic-nerve stimulation. This stimulation is intended to strengthen a weakened diaphragm (also known as Ventilator Induced Diaphragm Disfunction (VIDD)), already atrophied by mechanical ventilation and is expected to help patients wean off the ventilator more rapidly. 
 
Reducing time on the ventilator decreases the risk of Ventilator-Induced Lung Injury (VILI), secondary pneumonias, and poor patient outcomes associated with prolonged mechanical ventilation.^2,3 Less ventilator time frees up ICU beds, resources and mechanical ventilators, potentially improving ICU throughput and effectively reducing ventilator burden by a projected 26 percent in patients during this COVID crisis.
 
“The COVID-19 pandemic, also known as SARS-COVID-2, has stimulated tremendous innovation to improve outcomes for these patients,” said Doug Evans, CEO Lungpacer Medical Inc. “I am very proud of the Lungpacer team who have worked diligently to make this therapy available in a very short period of time, and I want to thank the FDA for their timely review and support. We are excited for the opportunity to provide healthcare professionals with access to the Lungpacer therapy to help their critically ill patients.”
 
Devices that meet certain criteria for safety, performance, and labeling have been authorized for emergency use. The Lungpacer Diaphragm Pacing Therapy System is authorized for use in healthcare settings to assist in weaning intubated patients determined by their healthcare provider to be at high risk of weaning failure off ventilators during the COVID-19 pandemic. Treatment is for a maximum of 30 days.

The Lungpacer DPTS has neither been cleared or approved for the indication to assist in weaning patients off ventilators in healthcare settings during the COVID-19 pandemic;
The Lungpacer DPTS has been authorized for the above emergency use by FDA under an EUA;
The Lungpacer DPTS has been authorized only for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of medical devices under section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner.
 
References
¹ Ataya A, Silverman EP, Bagchi A, Sarwal A, Criner GJ, McDonagh DL. Temporary Transvenous Diaphragmatic Neurostimulation in Prolonged Mechanically Ventilated Patients: A Feasibility Trial (RESCUE 1). Crit Care Expl, 2020; 2:e0106 DOI: 10.1097/CCE.0000000000000106
² Boles J. Weaning from Mechanical Ventilation. Eur Respir J., 2007; 29:1033-56.
³ Béduneau, G. Epidemiology of Weaning Outcome according to a New Definition. The WIND Study. Am J Respir Crit Care Med. 2017; 195(6):772-783