What are Ventilators and How They Work for Patients With COVID-19?

​Ventilators are usually needed to treat patients with severe types of COVID-19. These devices are pieces of equipment that are currently in short supply in some hot places around the world, according to reports made by some medical staff.

However, those unfamiliar with these pieces of medical devices might not know what exactly they do and why they are so important in treating patients with the novel coronavirus.

What are Those Ventilators?

Ventilators provide oxygen to the lungs, which is crucial in treating severe lung affections, Dr. Azad Mashari, a Toronto-based anesthesiologist and lecturer in the University of Toronto’s department of anesthesia, said. The coronavirus triggers a respiratory condition that can make it challenging for people to breathe.

“Ventilators are not a treatment, per se, they’re considered what’s called supportive therapy,” Mashari said.

Normally, infections are treated with antibiotics, and ventilators are used to help the lungs while other issues are addressed.

“The problem with COVID-19-related lung infections, however, is that there are currently no known effective treatments,” said Dr. Joseph Fisher, a senior scientist at the Toronto General Hospital Research Institute and co-founder of Thornhill Medical. “Perhaps there’ll be some anti-viral medications coming out in the near future, but there’s not much we can do about them [now].”

How do Ventilators Work?

Ventilators are usually employed in intensive care medicine and emergency medicine but are useful when a patient undergoing surgery is strongly anesthetized as well. There are two kinds of ventilators​, according to Dr. Mashari: non-invasive and invasive.

The invasive devices are connected to an endotracheal tube, which is a plastic hose that is placed into the trachea via the mouth, and are the ones normally used in severe cases.

“The ventilator pushes a volume of gas equal to the size of breath in, that goes into the lungs, oxygen gets absorbed, carbon dioxide comes into the lungs, and then that volume comes out back to the ventilator,” Mashari explained. “The ventilator gets rid of that gas and pushes new gas in.”

For cases with milder symptoms of COVID-19, oxygen pushed through a non-invasive ventilator, which resembles a face mask, may be enough. Sometimes, when the lungs of a person are extremely affected, doctors need to use both in order to deliver high levels of pressure and oxygen.

“If your lungs are in really bad shape, not only do you need extra oxygen, but that effort of breathing becomes overwhelming,” Dr. Mashari said. “You no longer can just suck enough air in and blow it out with your own muscles; you need the support of the ventilator, which provides pressure to help with the breathing.”

Are Ventilators in Short Supply?

The novel coronavirus can make patients be on ventilators​ for a rather long period of time, which means that a hospital can only cope with as many people at once. Dr. Mashari also added that depending on the hospital and the type of work they do, there may be only a few ventilators​ in the facility.

“A hospital that does, say, primarily orthopedic surgery or relatively small or medium general surgery, they may not have as many ventilators outside the operating room,” he said. “Community hospitals in more remote, rural areas, they may not be doing much surgery at all. So they would often have a couple of ventilators for emergencies.”

For people suffering from COVID-19, their situation can be changeable, needing the attention of nurses or respiratory experts.

“Monitoring is everything because you’re basically walking on a tightrope,” Fisher said. “You need to give oxygen, but you can give too much; you need to have pressure, but you can have too much. So we need to know when to stop and what the optimum level of all the various ventilator parameters are.”​

Otherwise, people can lose their life not because of COVID-19, but because the high pressure of the gas damages the lungs.

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