Working as an engineer at NASA’s Jet Propulsion Laboratory, David Van Buren usually spends his time designing and building instruments for space telescopes or robots that will explore other worlds in our Solar System. But for the last month, Van Buren and a group of his colleagues at JPL have been working on a project that is truly unexplored terrain for them: making a ventilator to help patients sick with COVID-19.
While Van Buren had some previous experience in medical engineering, he’d never designed a ventilator before. But he and his co-workers at JPL are used to making things they don’t have any experience making. In fact, they’re used to making things that no one has experience making.
“When a scientist comes to us and says they want to go to a moon of Jupiter and drill into the ice and see what’s underneath, that’s something that’s never been done before,” Van Buren tells The Verge. “We’re used to looking at new problems — things people haven’t done before or at least that we haven’t done before — and figuring out how to do them.”
After a whirlwind 37 days of research, planning, and tinkering, a subset of engineers at JPL have created a prototype they’re calling the VITAL ventilator. A white digital box with a breathing tube attached, the ventilator is somewhere between the sophisticated high-end ventilators that the sickest patients need and a simple ambulatory bag that can be used as a temporary measure to quickly squeeze air into the lungs. The team didn’t want to interfere with the production of the more critical ventilators, so the VITAL ventilator is meant for the patients who still need breathing support but are not in the most dire conditions. It’s a temporary tool designed to last just three to four months in a hospital.
VITAL is tailored specifically for people with COVID-19, which helped to guide its design. “It’s pared down in all the things that it can do, to just retain those functions needed for COVID-19 patients,” says Van Buren.
Throughout January and February, Van Buren had been following the news about the spread of COVID-19 in China with growing concern. Pandemics have been on his mind ever since the outbreak of H1N1 in 2009 when his daughter had to be hospitalized because of the new flu strain.
When it became clear in early March that there was community spread of COVID-19 in Washington and California, Van Buren really started focusing on what he could do to help. Early models suggested that hospitals would not have enough capacity or equipment to handle the influx of COVID-19 patients. Van Buren figured JPL could be an asset in the fight. One day, he bumped into Rob Manning, JPL’s chief engineer, in the center’s cafeteria, and they started talking about what they could do. “We both had been thinking, given the circumstances, maybe the projects that we were spending our time on might not be the most important things we could be doing, given what we both recognized was about to happen,” Van Buren says.
Manning found money to form a small team, and the project kicked off on March 16th. The group contacted a pulmonologist named Michael Gurevitch who’s been working on ventilators for decades. He came in and told the team the exact requirements that were needed for ventilators, while a JPL employee took detailed notes on a giant whiteboard.
“We more or less applied the pattern we apply when we build an instrument to land on Mars and, say, drill through the surface and take measurements of what’s down below,” says Van Buren. “We engage with scientists. In this case, we engaged with the clinicians as to what exactly is needed, so that we can then engineer an instrument — or in this case, a ventilator.”
Eventually, other people at JPL joined the project, including Michelle Easter. Normally, she works on mechanisms known as actuators. These motors are used to deploy or rotate instruments like solar panels during a mission.
“Actuators are often a combination of mechanisms and electronics,” Easter tells The Verge. “And that’s exactly what the VITAL device is; it’s a mechanism that’s controlled by embedded electronics, and that type of design is something super comfortable for me.”
To make VITAL, the team tried to use as many common, off-the-shelf parts as possible, such as tubing, motors, valves, and electronics displays. That way, anyone manufacturing the device in the future wouldn’t need to special order anything needed for a more sophisticated ventilator. The team found that companies and vendors were eager to help provide supplies that could be scalable. And when they didn’t have what JPL needed, they gave them references.
“Companies were just opening up their Rolodexes and giving us the names of their competitors,” says Easter, “which is not what you think for a business mindset. But people threw all of the traditional competition out the window.”
Eventually, the team settled on the final VITAL design. Because the machine is tailored for COVID-19 patients, it’s focused on providing air delicately to stiff lungs — a hallmark symptom of the virus. Stiff lungs have a harder time expanding, so patients struggle to get enough air to breathe. VITAL is meant to provide enough air pressure to patients to inflate their lungs but not so much so that the lungs over-expand. The machine also works to ensure the lungs don’t completely deflate, either. COVID-19 patients have lung damage that makes the sides of their lungs inflamed and sticky. If all the air goes out of their lungs and the sides touch each other, they might stick together and make it even harder to open back up again. So VITAL tries to keep the lungs slightly inflated whenever patients exhale.
Now that the team has a working prototype, they’ve moved on to environmental testing with the device. Whenever NASA sends a spacecraft to another world, each vehicle must be subjected to extreme conditions — such as wide-ranging temperatures, intense vibrations, loud sounds, and more — to see if it can withstand the harsh environment of space. Many of those same tests are needed to qualify medical equipment, too, and JPL has the facilities to run them, including a giant vacuum chamber and setups to shake hardware rigorously.
“We build spacecraft not medical devices, but there are so many similar elements, because they both have to be extremely high reliability systems — for different reasons,” says Easter. “For spacecraft, once you put it up in space, you will never be able to go and fix it. So we have to verify that it’s absolutely perfect and works exactly as we expect in all conditions. Then, of course, for the medical devices, we’re connecting this to a human; we have to verify that we’re not going to hurt a person. They’re both very, very important.”
Since the Food and Drug Administration is encouraging organizations to create new devices quickly to combat COVID-19, many of the tests usually required to certify equipment are no longer needed. But JPL still has to do elevation testing with VITAL to see if the machine will work in places like Denver, for instance. They also need to do electromagnetic interference testing, which will determine if VITAL can operate normally if someone is, say, talking on a cellphone nearby.
While the final round of testing is being completed, JPL is awaiting word from the FDA on whether VITAL will receive an emergency use authorization. Once they get approval, the team will then send the design off to companies that can produce VITAL en masse and deliver the ventilators to hospitals in need. “We don’t do production,” says Van Buren. “We do make one or two of a kind, and we send them off to Mars or Saturn or somewhere. And so we have engaged a couple of companies to help us understand the mass production aspects.”
It’s unclear how the team will proceed when the VITAL ventilator is shipped out into the world. Many of the people on the team put their normal projects on pause to get this ventilator ready as soon as possible. They’ll likely go back to designing interplanetary space probes very soon, but they’ve been buoyed by their brief stint in the medical world.
“I think everybody on the team is just so grateful that we have something positive to contribute in our brainpower and our teamwork,” says Easter. “It definitely helps us to feel empowered in an otherwise powerless kind of situation.”