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Mechanical Ventilator Milano (MVM): A Novel Mechanical Ventilator Designed for Mass Scale Production in Response to the COVID-19 Pandemics

We present here the design of the Mechanical Ventilator Milano (MVM), a novel mechanical ventilator designed for mass scale production in response to the COVID-19 pandemics, to compensate for the dramatic shortage of such ventilators in many countries. This ventilator is an electro-mechanical equivalent of the old, reliable Manley Ventilator. Our design is optimized to permit large sale production in short time and at a limited cost, relying on off-the-shelf components, readily available worldwide from hardware suppliers. Operation of the MVM requires only a source of compressed oxygen (or compressed medical air) and electrical power. The MVM control and monitoring unit can be connected and networked via WiFi so that no additional electrical connections are necessary other than the connection to the electrical power. At this stage the MVM is not a certified medical device. Construction of the first prototypes is starting with a team of engineers, scientists and computing experts. The purpose of this paper is to disseminate the conceptual design of the MVM broadly and to solicit feedback from the scientific and medical community to speed the process of review, improvement and possible implementation.

Galbiati, C.↗

Electrochemical Solutions for Advanced Life Support

The Oxygen Generating Assembly (OGA) on-board the International Space Station (ISS) employs a polymer electrolyte membrane (PEM) water electrolysis cell stack to electrochemically dissociate water into its two components – oxygen and hydrogen. Oxygen is provided to the cabin atmosphere for crew respiration while the hydrogen is delivered to a carbon dioxide reduction system to recover oxygen as water. The design of the OGA evolved over a number of years to arrive at the system solution that is currently operational on ISS. Future manned missions to space will require advanced technologies that eliminate the need for resupply from earth and feature in-situ resource utilization to sustain crew life and to provide useful materials to the crew. The architects planning such missions should consider all potential solutions at their disposal to arrive at an optimal vehicle solution that minimizes crew maintenance time, launch weight, installed volume and energy consumption demands. Skyre is developing new technologies through funding from NASA, the Department of Energy, and internal investment based on PEM technology that could become an integral part of these new vehicle solutions. At varying stages of Technology Readiness Level (TRL) are: an oxygen concentrator and compressor that can separate oxygen from an air stream and provide an enriched oxygen resource for crew medical use and space suit recharge without any moving parts in the pure oxygen stream; a regenerative carbon dioxide removal system featuring a PEM-based sorbent regenerator; a carbon dioxide reduction system that electrochemically produces organic compounds that could serve as fuels or as a useful intermediary to more beneficial compounds; and an electrochemical hydrogen separator and compressor for hydrogen recycle. The technical maturity of these projects is presented along with pertinent performance test data that could be beneficial in future study efforts.

Roy, Robert J.↗

Spinoff 2012

Topics covered include: Water Treatment Technologies Inspire Healthy Beverages; Dietary Formulas Fortify Antioxidant Supplements; Rovers Pave the Way for Hospital Robots; Dry Electrodes Facilitate Remote Health Monitoring; Telescope Innovations Improve Speed, Accuracy of Eye Surgery; Superconductors Enable Lower Cost MRI Systems; Anti-Icing Formulas Prevent Train Delays; Shuttle Repair Tools Automate Vehicle Maintenance; Pressure-Sensitive Paints Advance Rotorcraft Design Testing; Speech Recognition Interfaces Improve Flight Safety; Polymers Advance Heat Management Materials for Vehicles; Wireless Sensors Pinpoint Rotorcraft Troubles; Ultrasonic Detectors Safely Identify Dangerous, Costly Leaks; Detectors Ensure Function, Safety of Aircraft Wiring; Emergency Systems Save Tens of Thousands of Lives; Oxygen Assessments Ensure Safer Medical Devices; Collaborative Platforms Aid Emergency Decision Making; Space-Inspired Trailers Encourage Exploration on Earth; Ultra-Thin Coatings Beautify Art; Spacesuit Materials Add Comfort to Undergarments; Gigapixel Images Connect Sports Teams with Fans; Satellite Maps Deliver More Realistic Gaming; Elemental Scanning Devices Authenticate Works of Art; Microradiometers Reveal Ocean Health, Climate Change; Sensors Enable Plants to Text Message Farmers; Efficient Cells Cut the Cost of Solar Power; Shuttle Topography Data Inform Solar Power Analysis; Photocatalytic Solutions Create Self-Cleaning Surfaces; Concentrators Enhance Solar Power Systems; Innovative Coatings Potentially Lower Facility Maintenance Costs; Simulation Packages Expand Aircraft Design Options; Web Solutions Inspire Cloud Computing Software; Behavior Prediction Tools Strengthen Nanoelectronics; Power Converters Secure Electronics in Harsh Environments; Diagnostics Tools Identify Faults Prior to Failure; Archiving Innovations Preserve Essential Historical Records; Meter Designs Reduce Operation Costs for Industry; Commercial Platforms Allow Affordable Space Research; Fiber Optics Deliver Real-Time Structural Monitoring; Camera Systems Rapidly Scan Large Structures; Terahertz Lasers Reveal Information for 3D Images; Thin Films Protect Electronics from Heat and Radiation; Interferometers Sharpen Measurements for Better Telescopes; and Vision Systems Illuminate Industrial Processes.

Source record↗

Analysis of Advanced Respiratory Support Onboard ISS and CCV

NASA is collaborating with private entities for the development of commercial space vehicles. The Space and Clinical Operations Division was tasked to review the oxygen and respiratory support system and recommend what capabilities, if any, the vehicle should have to support the return of an ill or injured crewmember. The Integrated Medical Model (IMM) was utilized as a data source for the development of these recommendations. The Integrated Medical Model (IMM) was used to simulate a six month, six crew, International Space Station (ISS) mission. Three medical system scenarios were considered based on the availability of (1) oxygen only, (2) oxygen and a ventilator, or (3) neither oxygen nor ventilator. The IMM analysis provided probability estimates of medical events that would require either oxygen or ventilator support. It also provided estimates of crew health, the probability of evacuation, and the probability of loss of crew life secondary to medical events for each of the three medical system scenarios. These IMM outputs were used as objective data to enable evidence‐based decisions regarding oxygen and respiratory support system requirements for commercial crew vehicles. The IMM provides data that may be utilized to support informed decisions regarding the development of medical systems for commercial crew vehicles.

Shah, Ronak V.↗

Comparison of aerobic fitness and space motion sickness during the Shuttle program

Space motion sickness (SMS) is an important problem for short-duration space flight; 71 percent of STS crewmembers develop SMS symptoms. The search for effective countermeasures and factors that correlate with sensitivity has been extensive. Recently, several investigators have linked aerobic fitness with motion sickness sensitivity in the 1-G or high-G environment. This paper compares the aerobic fitness of 125 Shuttle crewmembers with their SMS symptom category. Aerobic fitness data were obtained from the exercise tolerance test conducted nearest the time of launch. SMS data were derived from the medical debrief summaries. Mean maximum oxygen consumption values for crewmembers in four SMS categories (none, mild, moderate, severe) were 44.55, 44.08, 46.5, and 44.24 ml/kg per min, respectively. Scattergrams with linear regression analysis, comparing aerobic fitness and SMS symptom classification are presented. Correlation coefficients comparing SMS categories vs. aerobic fitness for men and women reveal no definite relationship between the two factors.

Jennings, Richard T.↗

Miniature oxygen resuscitator

Miniature, portable resuscitation system is used during evacuation of patients to medical facilities. A carrying case contains a modified resuscitator head, cylinder of oxygen, two-stage oxygen regulator, low pressure tube, and a mask for mouth and nose.

Johnson, G.↗

The organism and the habitation atmosphere

Experimental data is examined on the study of the influence of the different parameters of the atmosphere on the organism for the purpose of making a physiological determination of the permissible oxygen concentrations in inhabited airtight compartments. The application of high oxygen concentrations for respiration and for medical purposes are considered. Data is presented on the evolution of the atmosphere and of the role of O2 in the process of the evolutionary development of living beings; the influence of an organism of an artificial, high and low oxygen concentration atmospheres; the laws of oxygen permeation into fluid media of the organism; the biological role of inert gases; etc. The relationship between the gas medium of habitation and reactivity of the organism is determined.

Agadzhanyan, N. A.↗

Spacecraft material flammability testing and configurations

Material and configuration testing for the Space Shuttle is mainly at 30 percent oxygen concentration at 70 kPa (10.2 psia). This is the worst case atmosphere during a mission and occurs 10 hours prior to extravehicular activity. The pressure is reduced from the nominal 101 kPa (14.7 paia) and the oxygen concentration is increased to 30 percent for medical reasons to prevent the bends during the extravehicular activity. NASA has tested many materials at 23.8, 25.9 and 30 percent oxygen levels for the Shuttle program. Data is given to show how flammability of material is affected by percentage of oxygen for those materials that would be considered for spacecraft applications.

Ledoux, Paul W.↗

Oxygen production using solid-state zirconia electrolyte technology

High purity oxygen is required for a number of scientific, medical, and industrial applications. Traditionally, these needs have been met by cryogenic distillation or pressure swing adsorption systems designed to separate oxygen from air. Oxygen separation from air via solid-state zirconia electrolyte technology offers an alternative to these methods. The technology has several advantages over the traditional methods, including reliability, compactness, quiet operation, high purity output, and low power consumption.

Suitor, Jerry W.↗

JSC Director's Discretionary Fund 1992 Annual Report

Annual report of the Johnson Space Center Director's Discretionary Fund documenting effective use of resources. The $1,694,000 funding for FY92 was distributed among 27 projects. The projects are an overall aid to the NASA mission, as well as providing development opportunities for the science and engineering staff with eventual spinoff to commercial uses. Projects described include space-based medical research such as the use of stable isotopes of deuterium and oxygen to measure crew energy use and techniques for noninvasive motion sickness medication. Recycling essentials for space crew support is conducted in the Regenerative Life Support and the Hybrid Regenerative Water Recovery test beds. Two-phase fluid flow simulated under low-gravity conditions, hypervelocity particle impact on open mesh bumpers, and microcalorimetry to measure the long-term hydrazine/material compatibility were investigated. A patent application was made on a shape-memory-alloy release nut. Computer estimate of crew accommodations for advanced concepts was demonstrated. Training techniques were evaluated using multimedia and virtual environment. Upgrades of an electronic still camera provide high resolution images from orbit are presented.

Jenkins, Lyle↗

Technology Development to Support Human Health and Performance in Exploration Beyond Low Earth Orbit

In the course of defining the level of risks and mitigating the risks for exploration missions beyond low Earth orbit, NASA s Human Research Program (HRP) has identified the need for technology development in several areas. Long duration missions increase the risk of serious medical conditions due to limited options for return to Earth; no resupply; highly limited mass, power, volume; and communication delays. New space flight compatible medical capabilities required include: diagnostic imaging, oxygen concentrator, ventilator, laboratory analysis (saliva, blood, urine), kidney stone diagnosis & treatment, IV solution preparation and delivery. Maintenance of behavioral health in such an isolated, confined and extreme environment requires new sensory stimulation (e.g., virtual reality) technology. Unobtrusive monitoring of behavioral health and treatment methods are also required. Prolonged exposure to weightlessness deconditions bone, muscle, and the cardiovascular system. Novel exercise equipment or artificial gravity are necessary to prevent deconditioning. Monitoring of the degree of deconditioning is required to ensure that countermeasures are effective. New technologies are required in all the habitable volumes (e.g., suit, capsule, habitat, exploration vehicle, lander) to provide an adequate food system, and to meet human environmental standards for air, water, and surface contamination. Communication delays require the crew to be more autonomous. Onboard decision support tools that assist crew with real-time detection and diagnosis of vehicle and habitat operational anomalies will enable greater autonomy. Multi-use shield systems are required to provide shielding from solar particle events. The HRP is pursuing the development of these technologies in laboratories, flight analog environments and the ISS so that the human health and performance risks will be acceptable with the available resources.

Kundrot, C.E.↗

Astronaut Preflight Cardiovascular Variables Associated with Vascular Compliance are Highly Correlated with Post-Flight Eye Outcome Measures in the Visual Impairment Intracranial Pressure (VIIP) Syndrome Following Long Duration Spaceflight

The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti‐lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post‐flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio‐ each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical correlation between the eye outcomes and the twelve astronaut cardiovascular variables available for all 31 subjects. Results: A highly significant canonical correlation was observed among the canonical solutions (p<.00001), with an average best canonical correlation of.97. The results suggest a strong association between astronauts' measures of cardiovascular health and the seven eye outcomes of the VIIP syndrome used in this analysis. Furthermore, the "joint test" revealed a significant difference in cardiovascular profile between male and female astronauts (Prob > F = 0.00001). Overall, female astronauts demonstrated a significantly healthier cardiovascular status. Individually, the female astronauts had significantly healthier profiles on seven of twelve cardiovascular variables than the men (p values ranging from <0.0001 to <0.05). Male astronauts did not demonstrate significantly healthier values on any of the twelve cardiovascular variables measured

Otto, Christian↗

Hydrostatic Hyperbaric Chamber Ventilation System

The hydrostatic hyperbaric chamber (HHC) represents the merger of several technologies in development for NASA aerospace applications, harnessed to directly benefit global health. NASA has significant experience developing composite hyperbaric chambers for a variety of applications, including the treatment of medical conditions. NASA also has researched the application of water-filled vessels to increase tolerance of acceleration forces. The combination of these two applications has resulted in the hydrostatic chamber, which has been conceived as a safe, affordable means of making hyperbaric oxygen therapy available in the developing world for the treatment of a variety of medical conditions. Specifically, hyperbaric oxygen therapy is highly-desired as a possibly curative treatment for Buruli Ulcer, an infectious condition that afflicts children in sub-Saharan Africa. Hyperbaric oxygen therapy is simply too expensive and too dangerous to implement in the developing world using standard equipment. The hydrostatic hyperbaric chamber technology changes the paradigm. The HHC differs from standard hyperbaric chambers in that the majority of its volume is filled with water which is pressurized by oxygen being supplied in the portion of the chamber containing the patient s head. This greatly reduces the amount of oxygen required to sustain a hyperbaric atmosphere, thereby making the system more safe and economical to operate. An effort was taken to develop an HHC system to apply HBOT to children that is simple and robust enough to support transport, assembly, maintenance and operation in developing countries. This paper details the concept for an HHC ventilation and pressurization system that will provide controlled pressurization of the system, and provide adequate washout of carbon dioxide while the subject is enclosed in the confined space during the administration of the medical treatment. The concept took into consideration operational complexity, safety to the patient and operating personnel, and physiological considerations. The simple schematic, comprised of easily acquired commercial hardware, supports sustainability.

Sargusingh, Miriam M.↗

Low-Flammability PTFE for High-Oxygen Environments

Modified forming process removes volatile combustible materials. Flammability of cable-wrapping tape reduced by altering tape-manufacturing process. In new manufacturing process, tape formed by proprietary process of screw extrusion, followed by washing in solvent and drying. Tape then wrapped as before. Spectrogram taken after extrusion, washing, and drying shows lower hydrocarbon content. PTFE formed by new process suited to oxygen-rich environments. Safe in liquid oxygen of Space Shuttle tank and in medical uses; thin-wall shrinkable tubing in hospital test equipment, surgical instruments, and implants.

Walle, E.↗

Extraction technique for the determination of oxygen-18 in water using preevacuated glass vials

The need for a rapid, inexpensive technique for routine 18O/16O extraction from water has arisen recently through applications in the medical sciences and in hydrology. The traditional experimental technique for determining the oxygen isotope composition of water, the CO2-H2O equilibration method, is tedious, time consuming, and involves the use of custom-made glass apparatus. Furthermore, because of potential memory effects from one sample to the next, the glassware needs to be thoroughly cleaned between runs. A few attempts have been made to improve upon the method. Attempts to analyze water directly in the source of the mass spectrometer produced large memory effects and questionable results. Commercially available apparatus for automated extraction of 18O/16O from water is generally prohibitively expensive and often is designed to interface only with the manufacturer's own mass spectrometer. The method described in this paper utilizes inexpensive, off-the-shelf, preevacuated, glass vials. Preevacuated vials have been used by others for the isotopic analysis of breath CO2 and are well tested. The vials can be purchased in bulk from scientific apparatus suppliers at a relatively low cost. These are coupled with a simplified extraction line consisting of a stainless steel syringe needle and a glass cold trap. Vials are filled with CO2 and H2O and shaken in a constant-temperature water bath for at least 90 min. Since the vials are discarded after use, no cleaning is necessary, essentially eliminating any memory effect. Reproducibility is generally better than +/- 0.05%. The only reagents required are gaseous CO2 for equilibration, a dry ice/alcohol mixture for trapping water, and liquid nitrogen for transferring the CO2.

NASA Discipline Number 52-10↗

Gas Related Problems Related to Spacesuits

Dr. Jonathan B. Clark is an adjunct Associate Professor of Neurology and Space Medicine at Baylor College of Medicine. From 1997 to 2005, he worked at NASA as a six-time Space Shuttle crew surgeon and was chief of the Medical Operations Branch at the Johnson Space Center. During this event, Dr. Clark discussed the hazards of low oxygen partial pressure (hypoxia) and high CO2 concentration (hypercarbia). This is one event of a medical series delivered to the SKC Program by Dr. Clark. This series focuses on spacesuit medical lessons learned and medical safety aspects of the suit.

Jonathan B. Clark↗