The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

Concept of OperationsFor International Space Station Next-Generation Mechanical Ventilator

George Beck1 BA, RRT,David Kaczka2 MD PhD, Douglas Butler1 BS, Terrell M. Guess1,Douglas Hamilton1 MD PhD MSc PE, Paul Kent1 BS, ShannonMelton1 BS, Richard Pettys1 BS, Jack Rasbury1BS MS, Byron Smith MS, BME

1 Wyle LaboratoriesLife Sciences Systems & Services, Houston, TX

2 Departmentof Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore,MD

Background: Whenthe space shuttle is not docked, use of the Soyuz transport/escape vehicle formedical deorbit to earth from the International Space Station (ISS) requiresa change in philosophy for medical emergencies from one of stabilize and transport,to stabilize and manage. The current Autovent 2000 ventilator (Allied HealthProducts, Inc., St Louis, MO) provides adjustment of tidal volume and rate incontrol mode with additional breaths via a demand regulator. This ventilatoris not designed nor intended for extended management (24-48 hours). The projectsgoals were to identify requirements for a next-generation ventilator that couldoperate on the ISS, Soyuz and Shuttle, and determine if commercial-off-the-shelfproducts could be used.

Method: Atrade study was conducted of the transport ventilator market, 14 units wereidentified and evaluated based on information provided by the manufacturers.Categorical ratings were assigned for clinical capability, resource and operationaluse. Parallel efforts determined ISS resource capability, communications infrastructure,space medical requirements, and evaluated the applicability of closed-loop controlsystems.

Results: Functionalrequirements for the next ISS ventilator included: A/C, SIMV, CPAP, PS, noninvasiveventilation, monitoring (EtCO2, SpO2, Vt, VE, VO2,VCO2, PIP, PEEP, R, C), wireless operation, closed-loop control,simple user interface, remote control and monitoring via industry standard deviceand network communication protocols, and support hyperbaric operations. TheEagle 754M (Impact Instrumentation Inc., West Caldwell, NJ) was identified ashaving many of the desired features.

Experience: Therehave been smoke and toxic gas inhalation injuries during space operations however,none have required a ventilator. The evaluation team is a unique combinationof engineers, physicians, respiratory therapists and researchers. Their experienceencompasses many years of operational space medicine, biomedical engineeringand clinical medicine.

Conclusion: Decreasesin FRC and RV seen in microgravity may lead to premature airway closure, whileimprovements in V/Q and diffusion capacity may reduce the incidence of hypoxemiaassociated with cardiopulmonary conditions. Given the uncertainties, the nextgeneration ventilator will need to support the patient for an extended periodand be administered by a non-clinician on orbit. Such a unit must allow monitoringand control by remote physicians. Additional work is required to develop remotedigital monitoring and control as well as autonomous modes of operation. Thiswork was supported under contract to NASA, NAS9-97005.


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Concept of OperationsFor International Space Station Next-Generation Mechanical Ventilator