In February 2020, the 36th roll, 1st phase of "Journal of Forensic Medicine" was published on February 25th. An article named "a Report on the General Observation of the Necropsy of COVID-19" would be published. The corresponding author is Prof. Liang Liu, the Chairman of Hubei judicial appraisal association, the professor of Forensic Medicine Department, Tongji Medical College, Huazhong University of Science and Technology, was the principal member who undertook the anatomy. It said on the autopsy report that the pleural effusion of the patient was about 150mL each, and the pleural thickening on the right side was incrassated and formed a severe adhesion with the right lung, and a large amount of white viscous liquid could be seen in the incision of both lungs. Besides, the white foamy mucus was found in the trachea cavity, while gelatinous mucus was found in the right bronchus cavity. On the cut side of the lung, it can be seen that a large amount of viscous secretions spilled from the alveoli. According to the result of the report, the lesion of COVID-19 was gathered on the lungs, which was mainly caused the inflammatory response characterized by injury of the deep airway and alveolar.

 

 

Professor Liu pointed out that under the microscope, it could be seen that some mucus secretions appeared on the part of the patients' lung section. He further explained that the current biopsy results showed that the alveolar function of the patient might be damaged due to the COVID-19, and then the airway would be blocked by mucus, anoxia and hypoxia would occur clinically. Therefore, to improve the anoxia and hypoxia state of the patient, the airway should be opened, and the mucus should be diluted and dissolved. If the mucus is not dissolved, only supporting air and oxygen maybe fails to achieve the goal and may even get backfires in return.

 

 

 

At the same time, the situation in Hubei province is getting better while the number of infected people in the world continuing to rise. On February 27th, according to the National Health Commission of the People's Republic of China, there were 318 new definite cases of COVID-19 were confirmed in Hubei province, including 313 cases in Wuhan, and the death toll in Hubei province also dropped significantly. From February 10th to February 23th, there were about 116 deaths per day in Hubei province, with an average of 47 deaths in the last four days, and the number of decreasing trended to steady, which proved that the sputum suction machine held a positive influence to alleviate the patient's condition.

 

At present, in China, the standard method of clinical airway care in ICU is manual sputum aspiration. The action like this which relies on manual sputum aspiration and ventilation has a lot of disadvantages. Firstly, it may easily cause pneumonia. Secondly, it may cause airway injury, bleeding, scars, and related complications; also, it leads a severe pain in the process of sputum aspiration. Thirdly, it's unable to clear away the sputum in the left airway; much less to clean away the sputum on the far side of small airway. Finally, manual sputum aspiration is a risky procedure; every patient is supposed to take sputum aspirations several times per day, even dozens of times, which may lead to the heavy workload of medical workers.

 

Introduced in Israeli patent technology, with eight years of research and development, the "RuXin CoughSync" synchronous expectoration machine is entirely suitable for this epidemic. The Synchronous expectoration machine is mainly used to replace the manual sputum aspiration operation commonly used in clinical airway care in ICU around the world. Because of the advanced IL-MIE (In-Line Mechanical In-Exsufflation) technology, it could solve many disadvantages of manual sputum aspiration with its technical advantages obviously. The main function of synchronous expectoration machine is to use mature MIE (Mechanical In-Exsufflation) technology, and integrate with the monitoring and control system of ventilator synchronization, Without interfering with the inhaling phase of the ventilator, only uses the expiratory phase, by simulating a natural cough, a rapid exhalation is produced to drain sputum from the lung to the artificial airway and then drain to the outside of the patient's mouth. Compared with the traditional manual sputum aspiration method, this closed and indirect sputum aspiration method is not only increased the efficiency of sputum aspiration, but also capable of removing sputum from the whole lung or even the small distal airway. Besides, it has no damage to the patient's airway and has a little hemodynamic impact, which would make a high acceptance among the patients. At the same time, because of the sputum aspiration tube is prevented from entering the deep lung, the incidence rate of Ventilator-Associated Pneumonia (VAP) can be effectively reduced, and the ICU detention time of patients can be decreased as well. In addition, synchronous expectoration machine can work automatically, which will not only reduce the workload of medical staff and work intensity, but also could reduce the risk of patient safety, disease transmission and other related occupational risks of using manual sputum suction.

 

 

"Morality does not stop people from acting in long-distance; People in every country should adhere to moral principles". We would like to donate our fully automated expectoration machine to the world, which was cost $900,000 and developed and researched by the office of Israel's chief scientist for eight years. Let us work together to fight epidemics and overcome difficulties