What is a ventilator and why do some coronavirus patients need it? – National


Treating patients with severe cases of the new coronavirus disease often requires the use of ventilators – equipment that is lacking in some global hotspots.

But what exactly do ventilators do and why are they so important in the treatment of COVID-19 patients?

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Ventilators provide oxygen to the lungs, which is an important part of treating severe coronavirus cases, said Dr. Azad Mashari, a Toronto-based anesthesiologist and lecturer in the Department of Anesthesia at the University of Toronto.

The new coronavirus causes a respiratory infection that can make it difficult for people with COVID-19 – the disease caused by the virus – to breathe.

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“Ventilators are not a treatment in themselves, they are considered to be what is called supportive therapy,” said Mashari.

Typically, infections are treated with antibiotics, said Mashari, and ventilators are used to help the body function while the underlying problems are treated.

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Documenting the “turning point” of the COVID-19 pandemic

The problem with COVID-19-related lung infections, however, is that there is currently no known effective treatment, said Dr. Joseph Fisher, senior scientist at the Toronto General Hospital Research Institute and co-founder of Thornhill Medical.

“Maybe there will be antiviral drugs in the near future, but there is not much we can do about them” [now]Said Fisher.

This means that ventilators are used to help people breathe while health workers treat symptoms and hope they recover from COVID-19.

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Ventilators are primarily used in intensive care and emergency medicine, but are also used when a patient undergoing surgery is heavily anesthetized.

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There are two main types of ventilators, Mashari said: non-invasive ventilators and invasive ventilators.

Invasive ventilators are connected to an endotracheal tube – a plastic tube that enters through the mouth and into the trachea (trachea). These are the ones that are often used to treat the most serious COVID-19 cases.

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“The ventilator pushes a volume of gas equal to the size of the breath, which enters the lungs, oxygen is absorbed, carbon dioxide enters the lungs, and then that volume returns to the ventilator,” said Mashari.

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“The ventilator gets rid of this gas and pushes out new gas. “

For patients with milder cases of COVID-19, oxygen delivered by non-invasive means, such as a face mask, may be sufficient. But for patients with severely affected lungs, they often need both high pressure and oxygen levels, said Mashari.

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“If your lungs are really in bad shape, you not only need extra oxygen, but this breathing effort becomes overwhelming,” he said.

“You can no longer just suck in enough air and blow it with your own muscles, you need the support of the ventilator, which provides pressure to help breathing. “

How long are COVID-19 patients on ventilation?

For the majority of COVID-19 cases, patients do not need respirators, said Mashari. But for the minority who do, they can be on the machinery for 10 to 20 days. (As health experts learn more about COVID-19, the results may change, he said.)

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It is important to note, said the two doctors, that people with chronic conditions, the elderly and those with other underlying medical conditions are at higher risk of developing more severe symptoms of COVID-19.

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The ventilators also pose a risk of secondary infection, said Fisher, like ventilator-associated pneumonia. Fisher said this happens because when a patient has a tube in the throat, there is a chance that bacteria can get into it.

Unfortunately, research has revealed that some COVID-19 patients who end up on respirators do not survive.

In a Lancet study of the results of seriously ill patients with COVID-19 pneumonia in Wuhan, China, researchers found that the death rate was “considerable”.

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Coronavirus epidemic: the impact of COVID-19 on the global economy

In another Seattle area study, researchers looked at 24 patients admitted to the intensive care unit with severe acute COVID-19 respiratory syndrome and found half of them died between day 1 and day 18.

Why are fans rare?

COVID-19 may require patients to be ventilated for extended periods of time, which means that a hospital can only accommodate such a large number of patients at a time.

Mashari also said that depending on the hospital and the type of work they do, there may be only a few ventilators on site.

“Hospitals that perform, for example, mainly orthopedic surgery or relatively small or medium general surgery, may not have as many ventilators outside the operating room,” he said.

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“In community hospitals in more remote rural areas, they may not be doing a lot of surgery at all. So they often had a few fans for emergencies. “

In addition, fans are expensive equipment to maintain, store and operate. They also require continuous monitoring by health professionals.

For patients with COVID-19, their condition may be unstable and progressing rapidly, requiring the continuous attention of nurses or respiratory therapists.

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“Monitoring is everything because you’re basically walking on a tightrope,” said Fisher.

“You have to give oxygen but you can give too much; you need pressure but you can have too much. So we need to know when to stop and what is the optimal level for all of the different fan settings. “

Questions about COVID-19? Here are some things you should know:

Health authorities warn against all international travel. Return travelers are legally required to self-isolate for 14 days, starting March 26, in case they develop symptoms and to prevent the spread of the virus to others. Some provinces and territories have also implemented additional recommendations or enforcement measures to provide self-isolation for people returning to the region.

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Symptoms may include fever, cough, and difficulty breathing – very similar to a cold or the flu. Some people may develop a more serious illness. Those most at risk are the elderly and people with serious chronic conditions such as heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend washing your hands frequently and coughing up your sleeve. They also recommend minimizing contact with others, staying at home as much as possible, and keeping two meters away from others if you go out.

For full COVID-19 coverage by Global News, click here.

– With a file from Kerri Breen from Global News

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