Penlon and the ESO 2 Emergency Ventilator for COVID-19
At the start of the global pandemic, the international demand for ventilators rose almost instantly beyond the capability of the established suppliers to meet global needs. The UK has no manufacturing base for ICU ventilators, and therefore on 17 March the UK Government issued a ‘call to arms’ to produce up to 30,000 ventilators suitable for treatment of patients with COVID-19. An appropriate technology specification was rapidly drafted by the government, and the Rapid Manufacture Ventilator System (RMVS) was conceived.
Penlon, established 77 years ago and based in Abingdon, Oxfordshire, produces anaesthesia equipment for worldwide use. We quickly responded to this initiative by proposing the ESO 2 Emergency Ventilator, based on the existing AV-S anaesthesia ventilator platform, which met the essential requirements of the RMVS specification. The normal production of AV-S ventilators is around 500 per year, and it was obvious that the production demands were beyond Penlon’s capability on its own. Within days, a consortium called ‘VentilatorChallengeUK’ was set up to massively increase production, which besides Penlon included Ford, Siemens and Surface Technology International (STI).
Penlon produced an initial batch of ESO 2s to prove the concept and submitted them for MHRA and NHS approval. After review by a number of experienced ventilation specialists and use on patients with COVID-19, the application was successful. Thereafter Ford began to manufacture the ventilator and Siemens the breathing module and gas delivery system, and STI performed the final assembly. Penlon’s role is to take regulatory responsibility of the ESO 2 complete final test and product release. All of factory in Abingdon is now converted to final test stations for the ESO 2, with all other manufacturing being set aside; the current production rate of the ESO 2 is several hundred per day.
The ESO 2 is not an ICU ventilator, although it has some of their characteristics and capabilities. It has basic mandatory and support modes, and feedback from anaesthetists and intensivists with COVID-19 experience led to suggestions for revisions of the specification including weaning modes. A plan is being formulated to upgrade the manufactured units to include features including PEEP in spontaneous modes and apnoea-triggered pressure or volume ventilation.
The ESO 2 has always been described as an ‘emergency ventilator for the treatment of COVID-19’, and is designed to be easy to use, especially by anaesthetists working in an expanded ICU.
Under normal circumstances Penlon exports 95% of its production. When the Nightingale hospitals were established in March, we diverted all of our export orders of Prima 320Advance, 450 and 465 anaesthetic machines, as well as the ESO 2, to the NHS, and many were installed into the Nightingale Hospitals. Subsequently these units have been reassigned around the country to NHS hospitals to supplement their anaesthetic machine stock. From July the ESO 2 has become available for export, and is being offered to governments, purchasing groups and hospitals both direct from Penlon and also through the World Bank. This is of particular significance to South America and Africa that have, to date, made a limited response to upgrading COVID-19 treatment capacity.
Whether the government was right or wrong to radically increase emergency ventilator capacity will only be answered with the benefit of hindsight. However, if there are subsequent waves of COVID-19 that produce large numbers of patients who require ventilation, the Penlon ESO 2 will be available to fulfil this role in the UK and around the world.
Head of Products and Marketing, Penlon