Use of 3D Printing to Support COVID-19 Medical Supply Shortages: A Review

Figures & data

Figure 1. There are various medical devices that can be created via a 3D printer.

Specific biomaterials can be used to create potential N95 3D-printed mask prototypes (layers to ensure effective filtration), face shields, ventilation equipment, COVID specimen collection kits and medications.

Table 1. Research studies relevant to the development of 3D-printed clinical applications for COVID-19.

Medical device	Author	Application	Materials	3D-technology fabrication process	Ref.
N95 mask	Swennen et al.	N95 mask-respirator mask	Two reusable 3D-printed components (a face mask and a filter membrane support) and two disposable components (a head fixation band and a filter membrane)	Additive manufacturing, SLS 3D printer	[30]
	McAvoy et al.	N95 filtering facepiece 51 respirators (FFRs or ‘masks’)	Halyard H600 sterilization wrap	Additive manufacturing, SLS 3D printer	[31]
	Moore-Imbrie et al.	3D-printed mask adaptor	Silicone, multipurpose polyurethane resins	A carbon M2 3D printer	[32]
3D-printed face shield	Wesemann et al.	3D-printed face protective shield	PET	Fused deposition modeling printer	[33]
	Sapoval et al.	3D-printed face protective shield	PVC sheet	Fused deposition modeling (material extrusion technique)	[34]
	Lemarteleur et al.	3D-printed face protective shield	Polylactic acid, polyethylene terephthalate glycol or acrylonitrile butadiene styrene	Fused deposition modeling (material extrusion technique)	[35]
COVID-19 specimen collection kit	Sananès et al.	NP swabs	Thermoplastic polymer, ABS	PolyJet technology, fused deposition modeling	[36]
	Ford et al.	NP swabs	Surgical guide version 1 resin	Stereolithography	[37]
	Oland et al.	Medical lattice swab	Resin (the “lattice swab”)	Carbon digital light synthesis printing	[38]
	Oland et al.	Direct-printed NP swab	Biocompatible photocurable resin (the “origin KXG”)	Additive mass manufacturing	[38]
	Arjunan et al.	Auxetic nasopharyngeal swabs	Photopolymer	3D design only	[39]
Ventilation Equipment	Ayyıldız et al.	Splitter for use of a single ventilator	Acrylic resin	PolyJet technology	[40]
	Dhanani et al.	AMBU bag	PLA plastic gears	Rapid prototyping technologies (3D printing and 2D cutting)	[41]

ABS: Acrylonitrile butadiene styrene; AMBU: Artificial manual breathing unit; FFR: Filtering facepiece respirator; NP: Nasopharyngeal; PET: Polyethylene terephthalate; PLA: Polylactic acid; PVC: Polymerizing vinyl chloride; SLS: Selective laser sintering.

Table 2. Potential research studies relevant to the development of 3D-printed clinical applications for COVID-19.

Medical device	Application	Materials	3D-technology fabrication process	Research design/key findings	Ref.
N95 mask	Mask face seal	Acrylonitrile butadiene styrene	FDM	Improved contact pressure with 3D-printed face seal compared with use of 3M© 8210 N95 FFR respirator masks	[27]
	Respirator mask	Silicon	RP	Printed silicon masks through digital modeling prototyped by RP	[21]
	Respirator mask	SEBS + PP	ME3DP	Printed biocompatible thermoplastic elastomeric materials from PP/SEBS compositions based on a facile blending strategy	[30]
	Respirator mask	PP	3D melt electrospinning printing	Sequential fiber layering achieved with a fiber diameter of 16.4 ± 0.2 μm; direct-writing of polypropylene	[42]
Face shield	Face shield mask	Polycarbonate, polyethylene, polyester, polyvinyl chloride, polyethylene terephthalate, polylactic acid	FDM	3D-printed transparent face shield	[31]
COVID-19 specimen collection kit	NP/OP swabs	Polyethylene terephthalate (dacron), polyester mesh, nylon flocked swabs	FDM	Can produce 3D-printed NP/OP prototypes that are strong and flexible	[43]
	NP/OP swabs	Surgical guide resin	3D-printed test resin via SLA laser printing	Can produce NP/OP flexible swabs	[44]
Ventilation equipment	Ventilator valves	Polyamide, polysulfone, polycarbonate, silicone rubber, nylon and polyamide 12 (PA12)	Filament extrusion system	Can create valve has very thin holes and tubes, smaller than 0.8 m	[45,46]
	Mechanical BVM adaptors	PVC and polyethylene valve	Filament extrusion system	Can create adapters and valves to connect the AMBU bag to the face mask	[47]
	Venturi mask	PVC	Filament extrusion system	Can design custom masks that allow high oxygen flow of a known oxygen concentration to patients	[47]
	LMA	PVC, silicone	Filament extrusion system, RP	Can design custom adapters/ valves to connect the LMA to an oxygen source or an expiration tube; can also produce a mold of a silicon mask via RP	[47]
	Tracheal tube	PVC, silicone	Filament extrusion system, RP	Can create custom adapters/valves to connect the LMA to a regulated oxygen flow source (from ventilator to patient) or an expiration tube (from patient to ventilator)	[48]
	NRB	PVC	Filament extrusion system	Can produce custom adapters and valves to connect the mask to the oxygen source	[48]
	Mask or helmet for CPAP ventilation	Face mask – PVC, polycarbonate; face seal – silicon; polyurethane	Filament extrusion system, DOD 3D printing	Can produce custom adapters/valves connected to CPAP mask/helmet to oxygen source; can produce the clips/attachments that holds the mask pressed onto face	[46]
	Ventilator valves	Polyamide	Polymer-laser powder/SLS	Can be used to melt and fuse a powder together to build up layers of an object	[45,46]
Medication	3D-printed tablet	PVA filament + fluorescein	FF 3DP	Successful fabricating personalized-dose medicines or unit dosage forms with controlled-release profiles	[49]
	Modified-release drug-loaded tablets	PVA filaments + (IBD), 5-aminosalicylic acid (5-ASA, mesalazine) + 4-aminosalicylic acid (4-ASA)	FF 3DP	Successful results show that it is possible to tailor oral drug dosage and modified-release formulation	[50]
	Drug-loaded tablets	PEGDA + diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide + 4-aminosalicylic acid (4-ASA) + paracetamol (acetaminophen)	Stereolithography	SLA 3DP technology allows the manufacture of drug-loaded tablets with specific extended-release profiles	[51]
	Pharmaceutical bilayer tablets	Hydroxypropyl methylcellulose (HPMC 2208) + (Methocel™ K100M Premium) + PAA (Carbopol^® 974P NF) + MCC (Pharmacel^® 102) + SSG (Primojel^®)	Gel extrusion	Successful drug release through a hydrated HPMC gel layer	[52]
	3D-printed medicine	Kollicoat IR (75% PVA + 25% polyethylene glycol copolymer) + Eudragit L100-55 (50% methacrylic acid and 50% ethyl acrylate copolymer) + paracetamol (acetaminophen)	SLS	Demonstrated the suitability of SLS printing technique using medical powders and lasers for manufacturing	[17]
	Personalized 3D-printed drugs	Hydrogel + PEG + hydroxypropyl methylcellulose + poly acrylic acid + aspirin	Coaxial needle extrusion	Print-active pharmaceutical ingredients; create combinations of controlled dosing of drugs; personalized medication	[53]

ABS: Acrylonitrile butadiene styrene; AMBU: Artificial manual breathing unit; BVM: Bag valve mask; CPAP: Continuous positive airway pressure; DOD: Drop-on-demand; FDM: Fused-deposition modeling; FF 3DP: Fused-filament 3D printing; LMA: Laryngeal mask airway; MCC: Microcrystalline cellulose; ME3DP: Material extrusion 3D printing; N95 FFR: N95 filtering facepiece respirator; NRB: Nonrebreather mask; OP: Oropharyngeal; PAA: Poly(acrylic acid); PEG: Polyethylene glycol; PEGDA: Polyethylene glycol diacrylate; PP: Polypropylene; PVA: Polyvinyl alcohol; PVC: Polyvinyl chloride; RP: Rapid prototyping; SEBS: Styrene-(ethylene-butylene)-styrene; SLA: Stereolithography; SLS: Selective laser sintering; SSG: Sodium starch glycolate.

Table 3. Displays the 3D-imaging technology and key findings of several studies used to create N95 mask seals.

3D Technology	Research design/key findings	Ref.
3D laser-scanning method	Used a high-precision hand scanner, zgHandScan H100 captured up to 480,000 points per second	[27]
3D face scanner	Created three differently face models (small, medium and large) using a 3D face scanner and developed three corresponding respirators through digital modeling; designed three silicon respirator models via rapid prototyping method	[21]
SPG	Used to collect 3D images of subjects with and without wearing a molded, cup-shaped N95 FFRs; recorded geometric data from photographic images	[23]
3D face scanner	Used a minimal set of landmarks to derive contact area for a half-face mask on individual human faces	[22]
3D real-time surface-pressure mapping system	Mapping system simulated contact between six N95 FFRs and five digital headform models to understand contact pressure	[19]
MATLAB computer-based algorithm	Developed a computer-based algorithm to determine the contact area between the headform models and N95 FFRs	[20]
3D laser-scanning method	Recorded contact pressure between a respirator and a digital headform	[25]

N95 FFR: N95 filtering facepiece respirator; SPG: Stereophotogrammetry.

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