Breath of Life: Duke Inventors Secure $5M for Novel Oxygenation Startup

NOTE: VQ Biomedical is a Duke University start-up and DCP portfolio company resulting from the collaboration of Assistant Professor Tobias Straube (Pediatrics, SOM), Research Scientist Stewart Farling (CEE, Pratt), Professor Marc Deshusses (CEE, Pratt), and colleagues.

by Fedor Kossakovski and Ken Kingery

Tobias Straube, MD and his critical care team gathered around the bed of a young patient with a severe lung infection. They had placed her on a ventilator earlier that day as her lungs were failing, but her oxygen levels continued to drift dangerously lower. As they increased the ventilator to near-maximum settings, they debated whether it was time to utilize an intervention of last resort.

“We were going back and forth: Do we want to put her on this ECMO machine or not?” recalled Straube, a pediatric critical care physician at Duke University Health System, of this pivotal night several years ago.

ECMO, or extracorporeal membrane oxygenation, is a therapy for the sickest of patients whose heart and/or lungs are failing. ECMO involves pumping a patient’s blood out of their body, through an external artificial lung. This artificial lung adds oxygen and removes carbon dioxide as the blood flows back into the patient.

ECMO can be lifesaving but has significant inherent associated risks as it requires pumping the majority of the patient’s blood volume through the ECMO machine every minute. Caring for a patient on ECMO requires highly specialized technical expertise and staffing which has limited its availability to only about 10% of hospitals nationwide. Fortunately, Duke has extensive experience using ECMO and has received Platinum ECMO Center of Excellence designation by the Extracorporeal Life Support Organization.

“The Duke ECMO Program was one of the first ECMO programs in the country, starting in 1991,” said Desiree Bonadonna, Chief of Perfusion Services and Director of Extracorporeal Life Support at Duke University Health System. “We are a high-volume program that has been recognized for quality in extracorporeal support based on our care delivery and outcomes, efficiency, safety, education, and innovation.”

Knowing Duke’s strength in this procedure, after careful deliberation, Straube and the team decided that placing this young patient on ECMO would offer her the best chance for recovery. Her oxygen levels started improving and, as he left work that night, Straube was cautiously optimistic.

Unfortunately, when he returned the next morning, he discovered that this young patient suffered a serious brain bleed, a known ECMO complication, which would ultimately leave her with permanent brain damage even after her lungs recovered and healed.

Years later, the experience still gets to Straube.

“It is such a heavy-handed therapy, how is it that we only have ECMO, which is essentially a modified heart-lung bypass machine, as this last resort when the lungs continue to struggle despite the ventilator?” asked Straube.

He vowed to improve the situation.

Recently, he took a big step to making that a reality. Duke University start-up VQ Biomedical, which Straube and colleagues founded in order to further develop and commercialize their minimally-invasive catheter-based oxygenator, has recently announced the closing of a $1.65M seed stage fundraising round, led by Duke Capital Partners (DCP), Harbright Ventures, and the Wolfpack Investor Network (WIN). Further grant, contract, and loan support from the likes of Biomedical Advanced Research and Development Authority (BARDA), the North Carolina Biotechnology Center (NCBC), Defense Advanced Research Projects Agency (DARPA), and others brings the total up to $5M.

Straube initially worked through the problem on the back of a napkin: Could enough oxygen be delivered through a catheter inserted directly into the bloodstream? Could the oxygenator be put in the body to minimize or eliminate the risks of having to pump the patient’s blood through the artificial external lung as is required in ECMO?

He went to the library and began reading. Other teams had attempted such an approach years ago but failed due to inefficient gas exchange leading bulky devices that weren’t amenable to intravascular use. He learned from these previous attempts at intravascular gas exchange and came up with a novel solution of his own. But he needed help.

All hands on deck

First, Straube took advantage of the rich academic opportunities within Duke and reached out to the Pratt School for Engineering to collaborate.

He partnered with Bruce Klitzman, emeritus faculty with joint appointments in Surgery and Biomedical Engineering, to begin tackling this challenge. Together they tested Straube’s idea of using pressurized oxygen flowing through gas permeable hollow fiber membranes. This pressure-enhanced diffusion would allow for increased oxygen transfer while minimizing the size of the membrane oxygenator required for use in such an intravascular catheter. However, to further reduce the profile of the device and to decrease the risk of microbubble formation related to their high gas transfer, they would need further optimizations.

Thankfully, Professor of Civil and Environmental Engineering Marc Deshusses already had a potential answer from work directed at delivering oxygen to a different type of moving fluid.

“Delivering oxygen is the number one cost in wastewater treatment plants,” said Deshusses. “I had done some research in the past about ways of delivering oxygen without creating bubbles to decrease these costs, and it turned into a treasure trove of background for this project.”

The team turned to a Deshusses’s graduate student, Stewart Farling, who had been working on similar research for wastewater treatment as a capstone project. It didn’t take long for him to switch gears and focus on the potentially life-saving device instead.

Farling, who is now lead engineer at VQ Biomedical, was able to find a solution to the remaining hurdles to developing a working prototype. By mechanically moving the fibers across different angles within the bloodstream, they found they could avoid oversaturating the blood and creating bubbles. From there, it was only a matter of optimizing the membrane materials, oxygen flow, and movement of the fibers to get to a viable prototype device.

“We had a certain amount of luck, but also we had the right people with the right backgrounds working together collaboratively to solve this challenging problem,” said Straube.

Growing the team

The team continued getting support from Duke and, in 2022, the team was selected to participate in the annual Invented at Duke event put on by the Office for Translation & Commercialization (OTC).

Among the hundreds of attendees was Galen Robertson, a medical device serial entrepreneur with a love for getting companies off the ground in the Triangle area. He was there to catch up with his friends and Duke alumni Ashley Palmer and Joe Knight, who was the featured speaker following the acquisition of DCP portfolio company InnAVasc, where he was CEO. But Robertson was also checking out new start-up opportunities. He stopped by Straube and Farling’s booth and was hooked.

“I thought if this is successful, this would be the biggest impact I could have,” said Robertson. “I want to be a part of this, this is the right problem to be solving.”

Now, they worked in parallel on the science and the business. Robertson helped Straube and team form the new company and became the CEO.

“What Galen instilled in me early on is, at the end of the day, no matter how good the tech or the science is, it has to be a product that a physician can reach to and use,” said Straube.

The team started working more closely with OTC’s Duke New Ventures group to further develop their business strategy.

“Dan Estay, our Mentor in Residence, has been really helpful,” said Straube. “Not just mentoring us, but also facilitating introductions to other important folks in the local ecosystem and the medical technology industry.”

“VQ Biomedical’s intravascular oxygenation catheter is one of the most exciting innovations I have seen in my 30 plus years in the cardiovascular industry,” said Estay. “It has been a pleasure to work with Galen and Toby as a Mentor and I’m looking forward to continuing to support the team as a member of VQ Biomedical’s board of directors.”

Continuing to iterate on the scientific components, the team secured more translational funding from OTC’s Gilhuly Accelerator Fund, BME’s Duke-Coulter Translational Partnership, and North Carolina Biotechnology Center’s Translational Research Grant.

Earlier in 2024, a big one arrived: The team applied for and received a $750,000 contract from BARDA.

“We had to quickly put all the resources in place and then, bam! – now we’re a company,” said Straube. “It was a jump into the deep end.”

Accelerating the pace

As CEO of VQ Biomedical, Robertson leveraged all the translational funding and progress into a successful local seed round.

“Everyone I talked to said: ‘You have to go outside the Triangle.’ And I didn’t,” he said. “We were able to raise seed money right here.”

A key participant in the fundraising round is Duke Capital Partners, the early-stage venture investment arm of Duke University.

“At Duke Capital Partners, we are dedicated to turning Duke innovations into real-world solutions that improve lives,” said Kurt Schmidt, Managing Director of Duke Capital Partners. “Our investment in VQ Biomedical reflects our confidence in their team and their technology to treat respiratory failure.”

“I was very excited to have Duke Capital Partners come on board,” said Robertson. “Coming out of Duke, having them interested and investing – it looks good.”

Joe Knight, who Robertson did catch up with at the Invented at Duke event, is a DCP member and ended up joining the VQ Biomedical board.

With all these new resources, the pace is accelerating for VQ Biomedical. The team has tested the device with an animal model but outside the body. With the support of the BARDA contract, the next iteration of the device will be tested inside an animal. After that, the new $2.4M DARPA contract will help the team make the prototype even smaller and more efficient.

“Now, I’m holding a prototype that’s flexible, that can bend just like a catheter that I would put in a patient,” said Straube. “For me to feel that, see that this is real and it’s happening – it’s very exciting.”

Still, the team agrees that there is much to be done before it gets to human trials. But with continued support from Duke and the area, the VQ Biomedical team is looking forward to the challenge.

“The ecosystem here is ripe for medtech start-ups, and Duke is a key pillar of that,” said Robertson.

For other Duke innovators interested in invention, start-ups, and making an impact, Straube recommends tapping into the Duke innovation network early.

“If you have an idea, your job is to advocate for that idea – not solve it by yourself,” said Straube. “Reach out to the people around you. And, it turns out, there’s a lot of really smart people around here at Duke. So, take advantage of the cross-campus collaboration and resources at Duke.”

Have an invention? Disclose to OTC to start your innovation journey.