VBSA and VtTA members gathered virtually this July to hear Dr. Jason Bates, professor of Medicine, Molecular Physiology & Biophysics, and Electrical & Biomedical Engineering at UVM speak about "The Vermontilator: an Emergency Ventilator from UVM in Response to the COVID Crisis."

Dr. Bates' talk revolved around the story of how the Vermontilator was invented. In setting the scene, he outlined what was known about COVID and the progress of the virus up to the point when it was declared a pandemic on March 11. Doctors knew that symptoms were highly variable, but that the disease could progress to acute respiratory distress syndrome (ARDS) at which point patients needed ventilation.

On Friday, March 13th, Dr. Bates received a text from a colleague working in the hospital with Vermont's first COVID patient declaring that airway pressure release ventilation (APRV) was "da bomb" for COVID ARDS. Over the subsequent weekend, while thinking about the inevitability of equipment shortages under pandemic conditions, he realized it was possible to make basic emergency APRV-style ventilators and drew up some of his ideas.

It's ironic, but ventilation of injured lungs, as in cases of ARDS, can cause a downward spiral of tissue damage. APRV minimizes that risk by holding the lungs inflated for most of each breathing cycle and then giving a brief exhale. APRV doesn't match a normal breathing pattern, but it does protect already vulnerable lungs from further injury.

March 17th, the Tuesday following Dr. Bates' weekend ventilator brainstorm, he was contacted by a group of engineers asking if he would like to join their team working on emergency ventilator concepts. He sent over the drawings he had made over the weekend. To his amazement, the engineers returned pictures of a working prototype that Thursday, about 24 hours later.

Dr. Bates reminded all of us that, even with a swift start by going from concept to working prototype in under a week, it's still a long road to achieve a product that is manufacturable at large scales and passes FDA review. Months after the prototype was built, the team is only now ready to manufacture a production model of the Vermontilator.

While Dr. Bates notes that "it's pretty clear we're not going to use this in Vermont; the social distancing is working and the hospitals were never overwhelmed," he has had international interest from countries where medical equipment resources are chronically low. From the beginning the team had agreed that the Vermontilator project goals were humanitarian. They do have to cover production costs, but they won't be making a profit.

Appropriate to its name, Dr. Bates attributed the success of the Vermontilator to widespread support from Vermont organizations, including UVM Innovations, UVM grad students, and the Vermont Manufacturing Extension Center. Dr. Bates comments, "It's a good thing we don't live in New Hampshire or the name wouldn't be as cute."