All You need to know about Ventilators

Overview

ventilator

ventilator

Ventilators are breathing machines that are used when patients are unable to breathe on their own. Certain conditions such as respiratory failure or a chronic illness can be the possible reasons for a patient to be on a ventilator.

There can be several synonyms of the word ventilator to address it like mechanical ventilation, respiratory and breathing machine.

Any obstruction in the air passage may interrupt the flow of oxygen into the blood leading to shortness of breath. Along with the accumulation of carbon dioxide in the bloodstream.

During covid-19 worldwide pandemic, ventilators saved many patients from death. The coronavirus is a deadly respiratory disease that causes acute respiratory distress syndrome(ARDS), which is a type of lung failure when the patient needs ventilator support for a prolonged duration.

Many companies across the globe are manufacturing ventilators and AgVa Health care company is one of the leading ventilator companies that manufacture ventilators with an installed base of more than 15000 ventilators across India.

To get the detailed information regarding the ventilator please read till the end.

What is a ventilator?

The lungs help in transferring oxygen from the air into the bloodstream and expel carbon dioxide from the body through inhalation and exhalation. This process is called respiration. When this process gets disturbed, the lungs get functionally disabled to maintain oxygenation.

A ventilator is a machine that provides mechanical breathing to a patient who is unable to breathe. The lungs transport oxygen to our whole body through the process of respiration.

Consequently, due to the lack of oxygen, the patient isn’t able to breathe. That can be fatal if ventilation isn’t provided in a timely manner.

A ventilator by moves air and oxygen helps the patient to breathe. That air is pushed by the ventilator to your windpipe.

In simple terms, a ventilator works by creating a positive pressure that forces the patient to inhale, with exhalation happening passively like in a balloon.

There are two methods of ventilation: invasive and non-invasive. Non-invasive methods such as continuous positive airway pressure are appropriate for patients who need ventilation for a short time like during resting or sleeping. On the other hand, an invasive method is used for the long-term use of a ventilator. This method is used in serious conditions when the patient is not able to maintain oxygenation by non-invasive methods. Invasive ventilation is performed by inserting a tube(endotracheal tube) through the mouth into the windpipe or by making an incision in the neck. A procedure called a tracheostomy. The tube is connected to a ventilator.

What is the use of a ventilator?

A ventilator has three important uses. A ventilator is required during general anaesthesia when the contained medicine can affect the person’s ability to breathe. A ventilator machine may also be used during the recovery period.

Most importantly, ventilators are useful when the patient cannot breathe on their own. The causes can be severe injury(including head and spinal cord injury), respiratory disease or any condition leading to lung failure.

To summarize the uses of ventilators:

  • Supply oxygen to the lungs
  • Eliminate carbon dioxide from the body
  • Provides support to patients to breathe
  • Used when the patient is under general anaesthesia

Although the ventilator is used in severe respiratory illnesses, it doesn’t cure any illness. The ventilator only assists the patient in breathing. It may be possible that some patients need long-term ventilator support. In these conditions, ventilators can be used outside hospitals or even at home (home mechanical ventilation).

How does the ventilator work?

 

The ventilator is a type of machine that is connected to an oxygen cylinder on an oxygen outlet and helps the patient to breathe. It happens with the help of an endotracheal tube, through the patient’s nose or mouth to their windpipe or trachea. The endotracheal tube is then connected to the ventilator.

The ventilator works through various modes and pushes oxygen-enriched air into the lungs to carry out respiration. Also, the ventilator maintains positive end-expiratory pressure to prevent the air sacs or alveoli from collapsing.

There are two invasive methods through which ventilation. These are intubation and tracheostomy.

Intubation:- in this procedure, the endotracheal tube is inserted through the patient’s throat into the windpipe. Thus, allows for easy passage of air and oxygen to reach the lungs.

Tracheostomy:- it’s a procedure where an incision on the trachea occurs when there is some obstruction in the airways. Also, tracheostomy is preferred when intubation is not possible and for long term ventilation.

One important thing to note here is that patients who have undergone intubation cannot be discharged and they will need constant medical supervision. While in the tracheostomy, the patient can be discharged for home-based ventilation or can continue to breathe through the tracheostomy spontaneously.

Types of the ventilator

Ventilators are of many types according to the patient’s requirements and age group. The difference among the various types is the modes of ventilators.

There are mainly two types of ventilators:-

  • Positive pressure ventilator
  • Negative pressure ventilator

Positive pressure ventilator:- this kind of ventilator creates a positive pressure, which pushes the lungs of the patient and increases the intrapulmonary pressure thus, helping in breathing.

These are the three types of positive pressure ventilators:-

  • Volume cycled ventilators:-  in these ventilators, the volume is set and pressure is measured. These ventilators can be used for the majority of patients.
  • Pressure cycled ventilators:- Pressure cycled ventilators are generally pneumatically powered. The pressure is predetermined and the tidal volume is measured. And it keeps pushing the positive pressure on the windpipe until it reaches the set pressure.
  • Time cycled ventilators:- the time is predetermined in these ventilators and it keeps pushing the positive pressure up to the set time.

Treatment of diseases caused by ventilators

 

Many patients need long term ventilator support or maybe lifetime ventilator support. In such conditions, a ventilator can be used outside the hospital under long term medical assistance or even at home. Ventilators do not cure any disease, rather it helps only in breathing.

Is it serious to be on a ventilator?

 

Yes, most of the time being on a ventilator can be serious. But not in every situation. The patients after general anaesthesia or surgery may require a ventilator as medical support. Also, premature neonates in NICU need ventilators just after birth. Because premature or ill babies cannot breathe on their own and need mechanical breathing for some time.

What are the complications while using a ventilator?

 

A ventilator undoubtedly saves many lives but, there are some complications also, which can be fatal to the patient. Two possible things can happen while the patient is on a ventilator, infection and lung damage.

Infection:- the endotracheal tube could allow harmful bacteria that could lead to an infection in the small air sacs in the lungs. This condition is called ventilator-associated pneumonia (VAP). It is a serious condition because the person may already have been sick and the infection may worsen the condition. In addition, the tube makes it difficult to expel out the debris through coughing which may irritate your lungs and become the reason for a lung infection. Although, the VAP could be treated with antibiotics. Also, patients with any viral lung infection can receive the VAP. Physicians call this condition superinfection.

Lung damage:- ventilators require the setting of pressure, amount, type and speed of the air that is to be pushed in and out of your lungs. Air mixed with oxygen is transferred to your lungs. But when the amount of oxygen is too much, it can be dangerous for your lungs.

Our lungs have a capacity to take oxygen-enriched air and when the air pressure or concentration of oxygen goes beyond it,  it can damage the lungs tissue. This is called ventilator-associated lung injury(VALI).

What is the cost of a ventilator in India?

According to the type of hospital, the cost of a patient to put on a ventilator can go from Rs 4000-10000 per day. The cost of an ICU ventilator developed by Indian scientists is approximately 5 lakhs. On an average, a medium-level ICU ventilator may cost around 5-10 lakhs. While some advanced level ventilators may cost around 10-20 lakhs.

Surprisingly,  the cost of AgVa ventilator is 5-10 times cheaper. In addition, during the covid-19 pandemic, AgVa Healthcare has installed above 15,000 ventilators which are more effective and economical as compared to other ventilators.

How would a ventilator be needed during the coronavirus?

 

In the research done so far, the doctors say that the coronavirus infection reaches from the windpipe to the lungs. The person affected by coronavirus feels difficulty in breathing. In simple words, a coronavirus victim cannot breathe and may die due to lack of oxygen. However, if they are put on ventilators, their lives may be saved. They will not die immediately from the infection.

Conclusion

When a person is unable to breathe, mechanical breathing is given by a machine known as a ventilator. This is why a ventilator is also called a respirator or a breathing machine. Ventilators were in huge demand amid covid-19 and have saved the lives of millions of covid-19 victims. Ventilators are of many types and work in different modes. The working of the ventilator is to push the air into the lungs through a tube. Thus, mimics the working of the lungs and carries out respiration.

Mechanical ventilation can either be invasive or non-invasive. For how long a person needs ventilator support depends upon the severity of the illness. Some patients need short term support,  while others may need it for the long term.


FAQs

When a ventilator is used for patients?

A ventilator is used when a person is severely injured, sedated or has a lung infection. Covid-19 is one of the examples of respiratory illness when the patient needs a ventilator in serious conditions.

What is a ventilator in a hospital?

A ventilator in a hospital is usually available in the ICU, where the patients who need mechanical breathing are put on the ventilators. Apart from this, there is a separate unit for the neonates in hospitals who need breathing support just after birth. The unit is called NICU(Neonatal Intensive Care Unit). Also, chronic ventilator-dependent patients in wards may be on ventilation.

What is a ventilator bed?

A ventilator bed is equipped with an oxygen cylinder, oxygen supply patient’s monitor and ventilator. Usually, large values of resources are required for each ventilator bed.

What is the difference between a ventilator and oxygen?

A ventilator is a machine that helps in mechanical breathing for severely ill patients. This machine is connected to an oxygen cylinder and helps in respiration. In simple words, it helps in the intake of oxygen and the out-take of carbon dioxide. Thus, the ventilator helps transport oxygen to the patient’s lungs.

At what oxygen level is a ventilator needed?

The oxygen saturation level of 95%-100% is considered normal. When it goes below 90% it can create severe conditions. And when it goes below 80% it can be fatal.

What is ventilator support?

Ventilator support is passive breathing through an endotracheal tube that pushes the air in your lungs. The patients require ventilator support when put on general anaesthesia and after surgery for recovery. Few patients may need long-term ventilatory support.

What happens when someone is on a ventilator?

When someone is on a ventilator, he will be getting mechanical ventilation through a face mask or a tube.  Usually, severely ill patients such as those with lung infection and lung diseases need ventilator support.

How serious is being put on a ventilator?

Being put on a ventilator is enough to predict the patient’s condition. Usually, people who cannot breathe due to any illness, injury or infection are put on a ventilator.  But there are some normal conditions also when patients need ventilation even if the situation is not worse. These conditions can be during the recovery period and when the patient is on general anaesthesia and for premature babies who need ventilation support.