Apr 30, 2020
“Staying safe, staying healthy” has become an utmost concern in recent times, and well-equipped healthcare infrastructure is becoming the essential need of countries across the globe. The Coronavirus (COVID-19) pandemic has highlighted some glaring gaps in the preparedness of the global healthcare industry, especially in the supply of reliable medical equipment and consumables. Most notably, the global demand for ventilators has risen by up to 10 times this year. Many manufacturers have already boosted their production by 30-50%, and they can’t deliver the 500 or 1,000% growth in production required. 
Breathing aids are a crucial part of the treatment procedure for patients severely infected with the virus, occasionally during transportation to the hospital by ambulance and often in intensive care units (ICUs). In terms of their core function, mechanical ventilators are sophisticated pumps that control the oxygen and/or airflow to and from the patient’s lungs, supporting them while the natural respiratory function deteriorates.
Mechanical ventilation could be an invasive or non-invasive type. The most basic type, known as non-invasive ventilation, is where breathing support is administered through a face or nasal mask to help a patient breathe easier. Invasive ventilation has a tube inserted into the person’s trachea to provide breathing support for their lungs. This type of ventilation is used when the viral infection has become severe by damaging the walls and linings of lung air sacs.
Bag Valve Mask (BVM) Resuscitators
The Bag Valve Mask (BVM), also known as the Ambu bag, is a basic mechanical resuscitator that consists of a self-inflating bladder that attaches to either a ventilation mask or tracheal tube via a pressure control valve. This basic life support system is used in an ambulance or a hospital waiting room until the patient can be brought into the Intensive Care Unit (ICU) of a hospital and put on a proper ventilator.
The breathing support through this resuscitator is established by squeezing the self-inflating bladder through a manual or automated mechanism that opens the valve, forcing air into the lungs. Releasing the bag allows the pressure inside the device to drop. The patient then passively exhales through the one-way valve. Typically, the pop-off valve can be adjusted to release at either higher or lower pressures, allowing the provider to compensate for the patient’s lungs’ compliance (ease of inflation). It also helps with avoiding the over-pressurization of the lungs with potential barotrauma.
Modern Mechanical Ventilators
A modern mechanical ventilator, an automated version of the conventional ventilator, is a highly sophisticated life support machine. This modern mechanical ventilator offers a superior level of care with minimal manual intervention. It’s comprised of a computerized microprocessor-controlled hat that sits on top of a mobile trolley. There’s an array of screens, dials, data cables, power cords, and gas tubes. These ventilators allow for adjustments like how long inhalation for a patient lasts, how much air is received, how often the air is received, the concentration of oxygen within the air, and how much pressure the patient’s lungs are inflated to the temperature and humidity of the air.
A small embedded system electronically controls these ventilators to enable customized air delivery and high-precision monitoring of pressure through digital sensors. The use of an Artificial Intelligence (AI) tool for decision support of the caretakers could be the future of modern mechanical ventilators. It can guide or help in decision-making regarding removal or continuation of a life support system as the timing of the ventilator removal is also important. Both premature extubation and prolonged ventilation are associated with higher mortality rates. These sophisticated machines may also feature digital controls for air pressure and a humidifier to match air to body temperature and add moisture – they offer the best chance of survival for the most at risk.
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