Respair Launches from University of Pittsburgh

It Takes a Village to Raise a University Startup, But an Entrepreneur is Key to Making it Happen

POSTED ON FEBRUARY 13, 2023 BY MIKE YEOMANS

There are many routes for a university-developed invention to travel before crossing the Rubicon to be licensed to an industry partner or become a startup company. And at Pitt there is an expanding array of resources available on campus and in the region for those interested in making that journey. But all roads lead back to the need for a dedicated and passionate entrepreneur to drive the project forward.That person can be the faculty member from whose research the innovation emerged. But more often it falls upon a postdoctoral fellow or other graduate student involved in the project, or an external partner coming in to navigate the often uneven and winding road from the lab to the market. Pitt’s latest startup, Respair, is emblematic of the role of intrepid entrepreneurs in making an impact for Pitt sponsored research and the robust ecosystem that has evolved to support them.

Ross Beresford demonstrates the seal that Respair’s new endotracheal tube provides to prevent bacteria from reaching the lungs and to secure the tube inside the trachea. Photo by Thomas Altany

A year after earning his master’s degree in bioengineering and medical product development from Pitt’s Swanson School of Engineering, Ross Beresford enjoyed a good job with a steady paycheck.

When invited to take the reins of a university-based innovation project with the potential – but hardly the guarantee — of eventually becoming a startup, he put in his two weeks’ notice and never looked back.

It’s not that Beresford disliked his job and the security it provided. He just couldn’t pass up the opportunity to help nurture a project he had encountered while a student as it evolved from a concept in the minds of two Pitt School of Medicine faculty and UPMC surgeons and into a prototype accelerating on the path from lab to the market, propelled by the multiple springboards in the Pitt innovation and entrepreneurship ecosystem.

Today, nearly a year since taking the plunge, Beresford has yet to collect a paycheck, but he has guided the project to becoming the latest startup to spin out of the university under the name Respair.

The company has landed a spot in the newest cohort of the AlphaLab Health life sciences startup incubator, and Beresford is currently pitching to potential investors as the company prepares to test its novel redesign of the endotracheal tube – one of the most common pieces of medical equipment in hospitals, but one that users report has significant defects and has not been improved upon in more than four decades.

“For projects like this to make the leap from the university to the market, there has to be somebody who will jump in with both feet,” Beresford said. “The PIs (principal investigators) are, rightfully, focused on their clinical responsibilities as physicians, and balancing those responsibilities with a startup’s needs can be a challenge without help. It’s a live or die scenario every day as a startup, and you need somebody there giving it life, but I can say that I’ve learned more in the past year than I did in five years in a classroom.”

The principal investigators in this case are Carl Snyderman, professor of otolaryngology and neurological surgery at the Pitt School of Medicine and Garrett Coyan, now fellow at Children’s Hospital of Philadelphia, who is a serial entrepreneur involved with two other Pitt startups, and is Respair’s Chief Medical Officer.

Snyderman has long been working with Swanson’s medical products innovation program on ideas for student projects. One of the problems he suggested that students explore related to a problem he has had throughout his surgical career with the tubes regularly moving around inside the patient’s trachea requiring constant monitoring to ensure they are in the proper position for effective respiration.

Current tubes are positioned in the trachea using a small inflatable balloon. Initial ideas for improving the stability of the tubes included adding more balloons. But this made the problem worse by making it more difficult to monitor and adjust the positioning of the tubes.

Coyan joined the project with another more urgent problem to solve. Poor sealing of the trachea by current tubes often results in aspiration of bacteria, leading to infections, like pneumonia. This insight became even more relevant with the onset of Covid pandemic, where many patients that required mechanical ventilation developed pneumonia. Beresford said up to 40 percent of patients who are put on ventilators longer than 2 days – approximately half a million people annually in the U.S. — develop an infection. Nearly a third of those patients will die from that infection.

The Respair endotracheal tube (left) is designed to prevent bacteria from entering the lungs for patients on a ventilator. Current tubes (right) do a poor job of sealing the trachea.

The team designed a new tube with “baffles”, flexible rings made of an ultra-soft material, that stabilize its position in the airway and form a comprehensive seal to prevent bacteria from infiltrating the lungs.

Close-up of the Respair prototype endotracheal tube. Photo by Thomas Altany.

“It’s a simple concept with great clinical potential,” Snyderman said.

The founders credit the Pitt innovation ecosystem for providing the support the project needed at every turn to accelerate on the path to commercialization.

“I was overwhelmed by the amount of support and resources, especially for someone new to the process like me,” Snyderman said.

The journey began in the Innovation Institute’s Pitt Ventures First Gear program, which leads new innovation projects through a process of customer discovery where their concepts are presented to potential customers for feedback. The team then develops and iterates on a value proposition for how their innovation may meet a customer’s unmet needs. It was during this time, working alongside an experienced business mentor and Innovation Institute entrepreneurs in residence, that the team’s emphasis shifted from stabilizing the position of the tubes to preventing infections.

The team then entered the Pitt Innovation Challenge (PInCh) competition sponsored by the Clinical and Translational Sciences Institute, receiving a $115,000 award. This was followed by a second-place finish in the Innovation Institute’s annual Michael G. Wells Student Healthcare Competition, earning the team an additional $10,000.

They also received a $21,000 grant from the Center for Medical Innovation at the engineering school.

“These programs and competitions brought a lot of momentum to the project building on what we learned in First Gear,” Beresford said. It also helped to recruit other student talent to the team, including Lauren Grice, who led the pitching to win the Wells competition and continues to work with the Respair team today. .

The Innovation Institute filed for intellectual property protection on the innovation in July 2021, and the team continued to work with the within the Swanson School on their prototypes.

“The IDEA lab supercharged the effort to get us around 100 prototypes to go and test,” Beresford said. “The stars aligned in a lot of different ways to keep us going.  We took advantage of everything Pitt had to offer for commercial translation.”

As the project gained momentum it was time to explore opportunities outside the University, so they entered the LifeX accelerator program and subsequently incorporated in late 2021.

By July 2022, they were ready to take an option on the intellectual property, which they converted to a full license in January of this year as they entered the AlphaLab Health startup incubator in Bellevue operated by Innovation Works, the region’s state-sponsored startup investment organization, and Allegheny Health Network.

“We have a dedicated office and lab space for the next several months as a basecamp to continue to grow,” Beresford said. “We are finalizing our prototype development, building a regulatory roadmap, and will be meeting with FDA within the next few months.”

Upon receiving investment, Beresford said the company will finalize our design, begin adding employees, and will select suppliers and vendors for manufacturing as it continues to work with Snyderman, Coyan and other clinical leads through their relationships with UPMC and AHN to drive trial and adoption of the device.

“As an engineer that’s why I came to Pittsburgh: the ability to have the clinical experts across the street. It’s an amazing concentration of people wanting to make an impact.”

For Beresford and the other Respair founders, making an impact is the biggest payoff of all.