What are ventilators, who needs them and why they are in short supply

What is mechanical ventilation?

Mechanical ventilation is artificial ventilation of the lungs. Devices that provide itMechanical ventilation, doctors are sometimes called ventilators (from English ventilation). Their main task is to help patients who, for some reason, cannot breathe on their own.

The ventilator pumps air into the lungs and removes carbon dioxide from them. Thus, he "breathes" for the patient, while his body is fighting disease or injury.

There are two optionsOverview of mechanical ventilation IVL:

1. Non-invasive ventilation of the lungs. This is when a special sealed mask or helmet is put on the patient through which oxygen is supplied under pressure.
2. Invasive ventilation of the lungs. It is used if the non-invasive option, for some reason, cannot provide the person with the required amount of oxygen in the blood. In this case, the trachea patient a so-called endotracheal tube is inserted through the mouth or nose and air is delivered almost directly into the lungs. Also, the tube can be inserted through an incision in the trachea, then it is called a tracheostomy tube.
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Why artificial lung ventilation is needed?

In the intensive care unit, mechanical ventilation is performed for everyone who has stopped breathing. The reasons for this can be different: pulmonary bleeding due to trauma, drowning, pneumonia, pulmonary or cerebral edema, poisoning with drugs or narcotic drugs, anaphylactic shock…

If a person does not breathe for 5 minutes or more, vital organs begin to die. First of all, the brain suffers.

The coronavirus also affects the lungs. About 5%Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) cases, the disease is very difficult and leads to respiratory failure. If such a patient is connected to a ventilator, his body will not suffer from a lack of oxygen.

Can mechanical ventilation cure coronavirus?

No. The main task of the apparatus is to enable the sick person to breathe, that is, to keep him alive, until the lungs (independently or with the help of drugs) start working again.

As soon as breathing is restored, the patient is removed from the ventilator.

Are there really not enough ventilators?

Yes. The shortage was especially acute in regions that have already faced powerful outbreaks COVID-19. For example, Italian LombardyFacing Covid-19 in Italy - Ethics, Logistics and Therapeutics on the Epidemic's Front Line or the US state of New York.

In Italy, due to a lack of ventilators, physicians were encouraged to make controversial decisions from a humanistic point of view. Thus, the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has issuedCLINICAL ETHICS RECOMMENDATIONS FOR THE ALLOCATION OF INTENSIVE CARE TREATMENTS, IN EXCEPTIONAL, RESOURCE ‑ LIMITED CIRCUMSTANCES recommendations in which he suggested that doctors carry out triage (triage) of patients, including by age. The older the victim, the less his chances of surviving, which means that it is not he who should go to the intensive care unit, but a younger and healthier person. In this way, Italy was forced to admit that medical resources, including ventilators, were not enough for everyone.

On April 2, the Governor of New York announcedN.Y.C. Death Toll Tops 1,500 as Cuomo Warns on Ventilatorsthat, given the sharp increase in the number of cases, the supply of ventilators will run out within six days.

With a downside880,000 more ventilators needed to cope with coronavirus outbreak, says analyst "Fans" collide not only with Italy and the United States, but also other countries - Spain, France, Great Britain... And this is understandable.

There are usually enough ventilators in intensive care units until a pandemic breaks out - which is unpredictable.

At the same time, it is very expensive and difficult to create supplies to keep them at hand for every firefighter.

Artificial ventilation of the lungs is a delicate and multifaceted process. It is not limited to the supply of oxygen and the removal of carbon dioxide. We need oxygen sources. Bronchoscopes to assess the condition of the lungs. Devices for cleansing the trachea and lungs. Monitors to monitor the patient's condition and change the parameters of artificial ventilation in accordance with it.

In general, the "bed in intensive care", which is necessary for every twentieth (according to other, less optimistic data880,000 more ventilators needed to cope with coronavirus outbreak, says analyst - every tenth) of the number of cases of COVID-19 is not just a bed, but a complex set of medical equipment that must be manually configured for each individual patient.

And what about mechanical ventilation in Russia?

As reportedThe Ministry of Health assessed the readiness to fight the coronavirus "RIA Novosti" with reference to the Ministry of Health, there are more than 47,000 artificial lung ventilation devices in the Russian Federation, so the country is ready for a possible increase in the number of infected with coronavirus.

By the end of May, hospitals will be additionally equipped with more than 8,000 ventilatorsVladimir Uyba on the preparedness of regions for coronavirus infection.

Deputy Minister of Health of the Russian Federation Vladimir Uyba

However, a lot depends on how the situation will develop and how many people will get sick.

Maybe you should buy a ventilator and, if anything, bring it to the hospital?

It may be possible to buy a device. But in general, this idea is so-so. For a variety of reasons.

Firstly, it is far from certain that the hospital will accept your “ventilator”. The transfer of medical equipment requires a huge number of different approvals, and they can refuse at any stage. In addition, doctors are responsibleResponsibility of doctors for inadequate provision of medical care for the treatment of each patient - up to criminal. And not everyone will take a risk, agreeing to use a "home" device medic.

Second, as mentioned above, the ventilator does not work alone. Dozens of other devices and consumables are required (for example, an oxygen source). In addition, specialists are needed to service the apparatus. Lot. It is unlikely that in the midst of a pandemic, you will be able to "buy" them along with the device.

Thirdly, it is simply unethical. The purchased device will gather dust at home, while people are dying in a nearby hospital due to a lack of “fans”. Are you ready to go for it?

And what should everyone do about it?

Today, states are actively increasing the production of vital devices. Only in Russia they are made over 1,000 per week. Private companies are also getting involved in this process.

For example, Ford management announcedFord, GE to produce 50,000 ventilators in 100 daysthat, in cooperation with General Electric, plans to produce 50 thousand "fans" in the next 100 days, and then supply up to 30 thousand units monthly.

Elon Musk also joined the process. On his Twitter, he suggestedElon Musk Send Tesla's existing ventilators worldwide free of charge. With one condition: "fans" must be installed immediately in hospitals to save human lives.

But this whole race will only partially solve the problem. In the midst of a pandemic, the world needs not only mechanical ventilation, but also qualified specialists who can work with them. There are a limited number of such pros. And it will take time to train new specialists.

Therefore, the answer to the question of what to do is expected and simple.

Do everything so as not to be among those who need mechanical ventilation, and hospitalization in general.

Quarantines all over the world are needed in order to reduce the number of cases, or at least stretch it in time - and to avoid a peak in which help will be needed at once by tens, or even hundreds of thousands of people.

Therefore, strictly follow the rules of the self-isolation regime announced in your region. And of course, take care of yourself: wash your hands more often, avoid crowded places and close contact with strangers, wean yourself from the habit of touching your face. This is the most effective way to help yourself and the world cope with the pandemic.

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