Ventilators and its usability in the ongoing pandemic of COVID-19

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The ongoing most notorious COVID-19 disease is primarily a respiratory problem and it worsens some of the pre-existing health conditions in the patients leading to death. During hospitalization, only a handful of cases of COVID-19 patients do require assisted breathing with the need for ventilators. With an increasing trend of the overall case of patient’s day-by-day, the need for ventilators and other medical equipment have increased exorbitantly and thus has created a gap between the demand and supply of ventilators and other medical equipment across several countries. It is being estimated by the experts that the demand for ventilators may reach up to 5-10% of the total COVID-19 cases after some time and thus the world may need millions of ventilators in the coming weeks or months to deal with the dreaded situation. The policymakers across the world have demanded the ventilator manufacturers in their region to rapidly increase the manufacturing to cope with the ever-increasing ventilator demands and at the same time, some countries have banned its export. Our country India has come up with several low-cost indigenous brands of ventilators. While the COVID-19 cases are still on the rise and it seems that there are not enough ventilators available in the hospitals right now for all of the needy patients. The urgent need of intensive care units (ICU) in the hospitals by plenty of patients at a time, can be averted by imposing a mandatory lockdown in a geographical area or state by reducing the social contact by 75%.

Indeed, a ventilator is a mechanical device that provides forced breathing to a patient suffering from lung disease or who is unable to breathe on his/her own, by moving breathable air into and out of the airways system (trachea and bronchial tubes) and lungs. The ventilators are one of the most important tools that hospitals have for maintaining critical patients of COVID-19 to remain alive during hospitalization. For a healthy person at rest, almost 7-8 liters of breathable air goes in and out of the lungs. The persistent failure of oxygen supply to the lungs may culminate in the death of the patient, and thus mechanical ventilation systems are also called life-critical systems.

The present-day ventilators are computerized and microprocessor-controlled machines that work as per the health parameters of the patients. Ventilators make an essential instrument found in the Intensive Care Unit (ICU) and in today’s fearful scenario of the pandemic of COVID-19 disease, the demand for installing enough ventilators is on the top priority of the hospitals. The COVID-19 disease caused by novel coronavirus badly affects the human respiratory system, where a patient initially feels painful breathing (dyspnoea) and later on becomes unable to breathe on his/her own. This way a modern-day ventilator is made up of a compressible air and oxygen reservoir with a turbine, some valves and tubes, and disposable tubing to be used as a “patient circuit”. The air reservoir is pneumatically compressed by a motor system several times per minute to supply either room-air or an air/oxygen mixture to the needy patient. The inhaling of air is an active process by the machine, while the exhaling is a passive process due to the lungs’ elasticity pushes air out of the body. This way, a ventilator blows air into the airways through a breathing tube. One end of the tubing is inserted into the patient’s windpipe (intubation) and the other end is attached to the ventilator. Due to the advancements in the technology, the modern-day ventilators are fitted with various online monitoring and alarm systems for patient-related parameters (age, the severity of disease and saturation of dissolved oxygen in the blood, gender, etc.) and alarm systems in ventilator machine functions e.g. air leakage, power failure, mechanical failure, etc. By the decades of the 1960s and 70s, the ventilators were called “Bird Respirator”.

The bitter truth is that still till today the number of COVID-19 cases is growing at an alarming pace worldwide and thus the hospitals will have an urgent need of enough ventilators available for the patients to keep them alive while undergoing available treatment. It is being reported that India has almost 40,000 ventilators in operation currently, which is undoubtedly grossly inadequate if COVID-19 cases were to surge, unfortunately. Statistics from China have shown that almost five percent of all COVID-19 patients do need ventilator support. A reported study conducted by operations research group of Indian Council of Medical Research (ICMR) has believed the lockdown has shifted the peak of the pandemic by an estimated 34-76 days and thus it has helped bring down the number of infections by 69-97% thereby allowing time for the healthcare system to shore up resources and infrastructure, especially several local-made indigenous ventilators.

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