This year you again can meet us at MEDICA Hall 10 / C03. We are excited to show case our OEM respiratory module and latest developments on sEMG technology.

MACAWI medical systems will participate this year, together with the companies DEMCON and Finapres, at the world’s largest medical fair, the MEDICA in Düsseldorf (Germany). This international event attracts many exhibitors and visitors from Germany, the United States, China, Great Britain, France and other countries. In last year’s Medica, more than 4500 exhibitors from more than 60 countries participated, and also this year a huge and varied spectrum of medical products and services will be presented.

16 – 19 November 2015
Düsseldorf, Germany

Medica website

Smarter ventilation thanks to better measurement

Dutch high-end technology supplier DEMCON has taken over Groningen-based company Inbiolab. Inbiolab is specialised in measuring muscle tension in respiratory muscles, in premature babies, for example. This expertise is interesting to DEMCON subsidiary Macawi Medical Systems, which develops and manufactures respirators for patients of all ages. ‘With their expertise we can make our technology even more intelligent’, says Macawi’s CTO Geert van Dijk.

The diaphragm plays an important role in breathing. When the diaphragm muscle tenses, it causes the chest cavity to expand, triggering inhalation. If the muscle tension can be measured in a patient on a ventilator, the respiration provided by the equipment can be synchronised to the patient’s own (weak) breathing. This delivers better results. The University Medical Center Groningen has for many years carried out research in cooperation with other university hospitals in the Netherlands and abroad. Inbiolab was established in 2010 to launch the technology under the name Dipha.

Sophisticated signal processing
The measurement method Inbiolab has developed is based on measurement of muscle tension, known as surface electromyogram (sEMG). This EMG is measured by sensors in patches or a band on the patient’s skin. A competitive product measures the EMG using a probe inserted into the oesophagus; this invasive method is stressful for patients, particularly premature babies. Technically, measuring through the skin, at a greater distance from the diaphragm, does pose a challenge. This is where Inbiolab’s expertise comes into play: measuring a weak EMG signal, which is also drowned by the 1,000-times stronger EMG activity of the nearby heart. It is a question of sophisticated signal processing using advanced hardware (amplifiers) and smart software (algorithms).

The future of respiration
This measurement method is very interesting for Macawi Medical Systems, which develops and manufactures artificial respiration equipment. A high-dynamic centrifugal blower makes it possible for a single piece of equipment to ventilate any patient, from premature babies to adults, just by changing the tubes. Macawi is continuously working to optimise this ventilation technology, says CTO Geert van Dijk. ‘We are searching for enhanced methods to synchronise breathing, for example. We are currently looking at changes in the flow or pressure, but these are the result of the patient’s own effort; so you’re already too late. If you can recognise at an earlier stage that the patient is beginning to inhale, you can help them and they will feel more comfortable. Inbiolab’s specialism allows us to make our technology even more intelligent. “Patient ventilation synchronisation” is the future of respiration.’ All reason for Macawi’s parent company DEMCON’s decision to take over Inbiolab.

Inbiolab, in turn, was open to the takeover, says project manager Jurryt Vellinga. ‘We had already been seeking contact with market parties such as manufacturers of respiration equipment for some time. Under the umbrella of DEMCON, we will be able to make use of their extensive engineering capabilities, their quality assurance system and other benefits. Macawi deals with the same parties as we do; so working together will deliver synergy.’ This also applies to HR, as Patrick Kleuskens, Managing Director of Macawi, will take responsibility for the day-to-day management of Inbiolab. Vellinga: ‘All concerns within the market will be removed by the combination of Inbiolab with DEMCON and Macawi.’

IC and more
The partners will set up new development projects, in the area of clinical applications. Inbiolab expects to launch its first product within two years, for the IC of premature babies. ‘We hope to expand this to the IC of adults soon after.’ He also sees opportunities for other applications, such as monitoring chronic lung patients or screening children experiencing breathing difficulties. As well as respiration, there are very different bodily functions that the Inbiolab technology could be used to measure. ‘We have already carried out a project based on measuring pelvic floor muscles in people who are incontinent. We can also measure EMG activity in the brain. This is carried out using patches on the patient’s skin, so needles no longer need to be inserted into the skull.’

The takeover of Inbiolab fits in with DEMCON’s strategy for growth in the international medical-technology market, explains Michiel Jannink, responsible for the medical business unit of the DEMCON Group as a whole. ‘They will strengthen Macawi’s range of respiration products. This is important for DEMCON, as Macawi reinforces our market position, particularly in Germany, and boosts our production. We also see opportunities for the development of other medical products.’ Inbiolab will continue to be based in Groningen for the time being. ‘The researchers have built up their life-sciences and high-tech network here’, says Jannink. ‘This is interesting for us. In time, they will form a springboard for DEMCON to expand its activities in the northern Netherlands.’

Enschede/Eindhoven, July 2014

DEMCON subsidiary delivers first series of ventilator modules

Developer of artificial respiration equipment Macawi Medical Systems of Eindhoven, taken over last year by the Enschede high-end technology supplier DEMCON, has delivered its first series of products. Macawi achieved this milestone in close cooperation with its parent company, which provided support for the further development and took care of the production. Geert van Dijk, Macawi’s CTO, explains: “Our customers find the combination of an engineering firm with so much ventilator expertise unique.”

Developer of artificial respiration equipment Macawi was set up in 2010 after the German Dräger Medical had decided to close its Dutch operation in Best. Geert van Dijk worked there as R&D Senior Technology Leader and had been involved since the seventies in the development of ventilator equipment and anaesthesia systems. Together with four Dräger colleagues, he did not want to allow the loss of this artificial respiration knowledge which is unique to the Netherlands. Under the name Macawi, they carried on with the development of an innovative high-dynamic centrifugal blower. This fits in with the trend to ventilate any patient, from premature infant to adult, with one device, by changing only the hoses. One year ago, DEMCON took over the business; its full name is now Macawi Medical Systems.

Together, Macawi and DEMCON developed a high dynamic control system for the centrifugal blower and they gave the module a redesign, reports Geert van Dijk, Macawi’s present CTO. “We made the module even better and more reliable.” The heart of Macawi’s centrifugal blower is a motor that, thanks to its clever construction and material choices, can reach no less than 90,000 rpm. This ensures that the ventilation can react to the patient immediately (at up to 200 breaths per minute), so that they never miss a breath. With its sophisticated control unit, the motor runs with low energy consumption and produces minimal heat and noise. This, added to the robust construction (also suitable for transport ventilator equipment in an ambulance or emergency helicopter) ensures a long service life – the design assumes 40,000 operating hours, or at least five years (in continuous service). “Our module is unique through the complete functionality it offers, and our customers also find the combination of an engineering firm with so much ventilator expertise unique.” DEMCON took care of getting the module production-ready, organised the supply chain, and set up an efficient assembly and test line in house. Due to this, Macawi is now ready to supply its technology in the form of an OEM module to manufacturers of complete ventilator systems and also to make customer-specific ventilator modules.

First delivery
In June, all was ready. Macawi could deliver the first series of 25 customer-specific ventilator modules to a customer in Germany. Contracts have been made with other European customers, and discussions are under way with potential buyers from places including Asia and the US. For the time being, 25 units a month are going to the first customer. Within two to three years, Macawi intends to ship 250 or more modules a month to different customers, depending on the market success of their new systems into which they are integrating the Macawi module.

Success factors
Besides the unique technology, Macawi’s Geert van Dijk points to the time-to-market as a success factor. “Our modules are interesting to customers because they no longer have to invest in the development. They can integrate the module straight into their systems and that gives them an edge in the market. Because we have already taken responsibility for the development. We ourselves possess all the specific knowledge for this and with DEMCON we absorb the peaks; their strength is that they have all the disciplines in house. Together, we have improved the reproducibility and service life of our modules.”

DEMCON (over 200 staff) is a high-end technology supplier of mechatronic products and systems, with as focus areas high-tech systems and medical devices. The company gained the certificate for ISO 13485 in 2011. This quality certificate for medical resources, just like the takeover of Macawi, fits in with the strategy to grow on the international medical market. The head office is situated in Enschede. There are subsidiary sites in Eindhoven, Amsterdam, Oldenzaal and Münster (Germany).