pleural

What it does

Pleural is an autonomous mucus management device for the 4 million UK individuals suffering from debilitating airway mucus. It uses intelligent analysis to provide the most effective treatment and monitoring to patients for relief and reduced infection risk.

Your inspiration

We have witnessed firsthand our relatives with mucus-related chronic respiratory conditions struggling to access the appropriate care. Unregulated mucus can lead to infections and exacerbations which increase the likelihood of hospitalisation and morbidity. Some of the luckier ones were offered chest physiotherapy, but had to travel for treatment. They also described anxiety due to limited understanding of the progression of their condition so we worked closely with patients with COPD, cystic fibrosis and bronchiectasis to develop a solution that could both provide effective treatment and regular condition monitoring.

How it works

Our device administers chest physiotherapy according to best clinical practice, which is traditionally done manually by a physiotherapist. We use a silicone cup to percuss the chest at a calculated force and frequency to mobilise mucus from the lungs. We realised a doctor’s finger-tapping percussion on a patient’s chest during auscultation generates impulse signals, which are intuitively interpreted alongside breathing sounds using a stethoscope to analyse the chest. This takes years of training but advances in machine learning have allowed us to train an AI to do most of the hard work. We discovered we could use the same percussive mechanism to provide the input for AI-powered auscultation and for the percussive chest clearance therapy itself so clearance and analysis happen in tandem. Users can confidently perform airway clearance therapy at home, with the device providing guidance and progress tracking through the companion app to ensure thorough treatment.

Design process

Pleural followed a patient-centred design method, using rapid experimentation and prototyping for effective co-creation with users. Continuous refinement based on user feedback resulted in a technically functional device that has the potential to improve patients' quality of life and reduce hospitalizations, but still needs thorough testing and refinement. Through interviews and observation, we built in-depth connections with the patient community and charity groups to understand their routines and pain points. We synthesized early ideas using trading card kits, capturing essential user insights and expert interview quotes. After this thorough research phase we identified an opportunity to deliver chest physiotherapy at home, whilst providing guidance and feedback. Several iterations of chest actuation mechanisms were tested including sonic sub frequencies, different attachments for delivering the impact on the body, and a spring-loaded design for consistent force delivery. Several ML techniques were evaluated for signal analysis. Methods included those derived from research into COVID cough diagnosis, audio of vibrating mucus filled silicone replicas of lung airways, as well as a specifically built testing rig to generate audio spectrograms that can then be further analysed.

How it is different

We offer a unique solution for patients with excessive mucus, enabling autonomous mucus clearance. Our device replicates chest physiotherapy, incorporating percussive impulses and audio analysis with machine learning to clear the lungs and evaluate mucus levels. We have developed the first electronic device that replicates comprehensive chest physiotherapy including all mechanical elements, positional guidance, breathing guidance, intelligent analysis and long-term monitoring. It empowers true autonomy for the user at home and is a beneficial care augmentation for medics. Other devices are solely percussion hammers or vibration transducers which are intimidating to use and without any assurance feedback. Our device is designed to ensure efficacy in clearing lungs and creating peace of mind. The only other way to get this assurance is through manual chest percussion from a practitioner, which is inconsistent, infrequent and tiring to perform.

Future plans

Pleural's mission is to empower individuals with respiratory conditions by developing a smart airway clearance device. Pleural aims to give users immediate relief from breathlessness, reduce infection risk, and enhance their ability to manage their lung condition. We want to be part of a healthcare revolution in which truly personalised, preventative healthcare is enabled by technology. Pleural has reached the final of start-up programs in London and received strong support from charitable organisations and awarding bodies. With further support, we will be able to bring the device to patients for testing and begin to make a real difference.

Awards

The Mayor's Entrepreneur Competition 2023 Finalist, London Imperial College Venture Capitalist Competition 2023 Semi-Finalist, London National University of Singapore Medical Grand Challenge 2023 Finalist, Singapore