Ventilators – the difference between life and death in CoronavirusVentilators – the difference between life and death in Coronavirus

According to the World Health Organization (WHO), one person in six can become seriously ill and can develop breathing difficulties due to Coronavirus. This has made ventilators critical as the devices have been successful in treating pneumonia, which causes inflammation in the lungs.

What does a ventilator do, and how does it help coronavirus sufferers?

According to the American Thoracic Society, a ventilator, also known as a mechanical ventilator, respirator, or a breathing machine, is a life support treatment that helps people breathe when they have difficulty breathing on their own. The machine pumps oxygen into the lungs and the body and helps to get rid of carbon dioxide through the lungs.

Simply put, a ventilator can help a patient by doing all or some of their breathing, and it’s better than a mask and other devices, as it can deliver higher levels of oxygen. The ventilator also has a humidifier, which adds heat and moisture to the medical air so that it can match the patient's body temperature.

In certain patients with COVID-19, the virus can cause pneumonia and severe inflammation. Therefore, the machine has become an important asset to combat Coronavirus, particularly among elderly and the immuno-compromised population, who could suffer respiratory troubles and multiple organ failure as the virus attacks the lungs.

A ventilator is connected to the patient through a tube placed into their mouth or nose and inserted into the windpipe. The process is referred to as intubation. In certain situations, patients may need to undergo surgery to have a hole made in their neck, and a tracheostomy or “trach” tube is inserted through the hole to the trachea. The ventilator then blows gas that consists of air, and oxygen if required into the lungs.

When treating a patient with COVID-19, a ventilator allows the medical team to support their breathing function. Reports have highlighted that even if the lung is failing, a ventilator could provide enough support and buy time for the medical team to help the patient overcome the infection, until the point where their lungs can regain function.

What are the risks of being on a ventilator?

However, a ventilator could cause damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs. And patients with COVID-19 often require very high levels of pressure and oxygen as their lungs have increased inflammation.

One of the other risks associated with ventilators is that the tube carrying air and extra oxygen to the lungs might end up being a pathway for dangerous germs. It has been reported that several patients who have been on the ventilator have been exposed to a problem known as ventilator-associated pneumonia.

Some studies have also pointed out that people who are conscious while on the ventilator might experience feelings of panic and sometimes the pain from the tube makes it difficult for patients to relax. Moreover, those who are attached to ventilators for a week or two could suffer long-term physical, mental and emotional issues and may experience post-traumatic stress disorder.

What kind of care does a person need when on a ventilator?

While ventilator machines have been saving many lives of those infected with Coronavirus, it requires a qualified person to operate it. These machines are not only complicated to build and procure, but they are also quite difficult to run and maintain. And while there is much discussion around the dearth of machines, there is less dialogue on the shortage of professionals such as intensive care physicians, anesthesiologists, intensive care nurses, and respiratory therapists to manage ventilators.

The decision to put a patient on the machine is made when it is clear that the lungs have become too inflamed. The level of sedation varies from person to person. A study found that most patients preferred to remain conscious and that having attentive carers helped their perceptions of being on a ventilator.

As the pandemic spreads, will there be enough ventilators?

The rapidly growing shortage of ventilators has become a matter of concern. In the U.S., President Donald Trump has told manufacturers, such as Ford and General Motors, to start making ventilators.

Furthermore, University College London engineers have worked with clinicians and Mercedes Formula One to build the Continuous Positive Airway Pressure (CPAP) device. It is being trialled at several London hospitals and if all goes well, the Mercedes-AMG-HPP group can begin building up to 1,000 of the machines per day. The CPAP device has received approval from the Medicines and Healthcare products Regulatory Agency.

Moreover, a team of scientists and engineers from Oxford University and King's College London has unveiled a low-cost design, which it says could be quickly put into production.