Ventilators ... Do you save the infected with the Corona virus? 10 questions

Dr.. Osama Abu Al-Rub

Hospitals around the world have become in urgent need of ventilator devices to help patients of the new Corona virus "Covid-19", which is spreading at an accelerated rate in Europe and the United States in particular, so how do these devices work, and does the survival of the person with corona under artificial respiration necessarily keeps him alive or That there are other factors that may lead to his death?

These and other questions are answered in this detailed report, which we have written in ten questions:

1- What is the nature of the ventilator?
Ventilator ventilator is a machine that provides mechanical ventilation by transporting oxygenated air to the lungs, to help a patient who cannot breathe alone or whose breathing is insufficient.

Respiratory devices can save a patient's life when a person cannot breathe properly or when he cannot breathe on his own at all.

2- Is it used for the purpose of treatment?
The ventilator is not a cure for a disease, but it is used during treatment to stabilize the patient's condition, for example in the case of patients with Corona virus, the ventilator does not treat the virus, but it allows the patient whose respiratory ability to survive has decreased, until his body recovers from the virus and defeats it, or Pending drug treatments.

3- What are the uses of a respirator?
There are many uses that are combined by the fact that a person is unable to breathe on his own or cannot breathe sufficiently, such as:

• While recovering from severe cases of the emerging virus "Covid-19" virus when a significant decline in respiratory function.
• During surgery when a person is under general anesthesia.
• After surgery and during recovery, sometimes the patient needs a breathing machine to help him breathe for hours or even days after surgery.
• While losing consciousness.
• Coma.
• Brain injuries.
• Chronic pulmonary embolism.
• Lung infection.
• Pneumonia.
• brain attack.
• The presence of injuries to the upper spinal cord.

4- How does a ventilator work?
The ventilator enters oxygen to the lungs and expels the carbon dioxide, including the use of a tube that connects the ventilator to the airways of the lung through the mouth or nose, and this is called "intubation".

In some serious or prolonged cases, the breathing tube is connected directly to the trachea through a small hole in the neck that is opened with surgery.

The ventilator uses pressure to push the oxygenated air into the lungs. The ventilator needs electricity to operate, and some types can work on the battery.

Although a ventilator can save a person's life, it increases the risk of lung infection, as the breathing tube can allow germs to enter the lungs.

5- Why do some SK patients need a ventilator?
To answer this question, we must explain what corona does to the lungs, as the virus attacks two specific groups of cells in the lungs, which are goblet cells and ciliated cells.

The goblet cells produce the mucus that forms a moisturizing layer on the respiratory tract, which is important to help maintain the moisture of the lungs, thus maintaining health.

The ciliary cells are cells with capillaries that point upward, and their function is to shovel any harmful substance suspended in mucus, such as bacteria, viruses, and dust particles, towards the throat to get rid of them.

The Corona virus infects these two groups of cells and begins to kill them, and its tissues begin to fall and collect in the lungs, and the lungs begin to become obstructed, which means that the patient has pneumonia.

Also there is another problem, which is that the body's immune system tries to respond because it realizes that the body is under attack, and this may lead to an overload of immunity, and then the immune system makes a major attack that damages healthy tissues in the lung, and this also may make breathing more difficult.

With the ability to breathe to decrease, the patient needs a ventilator, otherwise he may not be able to survive.

We point out here that the data indicate that 80% of patients may have no symptoms or have mild symptoms, and that only 20% need hospitalization, 5% of them will become critical, and 1-2% will die.

According to the operating room to deal with the outbreak of the Corona virus in Russia, about 40% of patients infected with the Corona virus in Moscow who are treated with respirators of the lungs are under the age of 40 years.

6- How long does the Corona patient need under the ventilator?
Dr. Joshua Dinson, a lung and critical condition specialist, told NBC News that most Corona patients usually use respirators for one to two weeks.

7- Does keeping the person with corona under artificial respiration necessarily keep him alive, or are there other factors that may lead to his death?

It must be emphasized here that using a ventilator means saving the life of the patient, without whom he will not be able to breathe.

However, with the use of ventilators, mortality may occur and to a lesser extent, and this depends on other factors such as the patient's age, the extent of damage to the lungs from the Corona virus and whether the patient has chronic diseases.

The respirator is crucial in caring for the person suffering from pulmonary failure that afflicts the patient in severe cases of corona, but it does not necessarily save the lives of patients.

8- Is the world ready?
There are serious concerns that in the event of a significant increase in the numbers of people infected with the Coronavirus, the hospitals will be filled and there will not be enough respirators, which could lead to deaths. Therefore, governments in various countries of the world are trying to increase the number of ventilated health services.

For example, in Germany, the head of the Robert Koch Institute, Lothar Wheeler, warned last Sunday that the number of people with coronavirus had exceeded the number of respirators in hospitals in the country, calling for taking this data into account.

He added, "Hospitals must be prepared in the best possible way ... and the absorptive capacity of the intensive care units should be raised to at least twice, to accommodate the largest possible number of Corona patients." Wheeler stressed that his country is still at the beginning of the epidemic, calling for it to be taken seriously.

According to the data of the German Statistics Department, the country includes 28 thousand intensive care units.

In the United States, officials in states severely affected by the Coronavirus demand President Donald Trump's administration and manufacturing companies to accelerate ventilator production to adapt to an increase in the number of patients requiring respiration.

US President Donald Trump tweeted, giving the green light to Ford, General Motors and Tesla to help boost ventilator production.

The French "PSA" group, which owns "Peugeot" and "Citroen", told AFP that it is looking "very seriously at the possibility" of joining the companies that manufacture these medical devices.

New York Mayor Bill de Palacio told CNN on Sunday that the city will need hundreds of more respirators within days and more masks, medical clothing and other supplies by April 5.

Louisiana Gov. John Bell Edwards said ventilators in New Orleans would be depleted around April 4 and state officials would not know if they would receive any other devices out of the national stockpile.

"Louisiana tried to order 12,000 artificial respirators from commercial companies and received 192," he told CBS's "Face the Truth" program.

"We have not yet received approval to obtain respirators from the national stock. I will continue to press for this and I hope we will get some of the rest," Edwards added.

US President Donald Trump told reporters on Sunday that hospitals that do not use ventilators will have to abandon them, noting that there is a hoarding of these devices.

Trump also said Friday that the United States will produce 100,000 artificial respirators within a hundred days, adding that he has appointed White House adviser Peter Navarro as coordinator of the Defense Production Act.

An industrial source told Reuters on Sunday that Britain had requested ten thousand respirators manufactured by a consortium of companies, including Ford, Airbus and Rolls-Royce, as part of its efforts to combat the Corona virus.

On Sunday, the senior minister in the British government, Michael Goff, said that the state-funded British National Health Service has just over 8,000 ventilators.

9- How did medical companies respond to this crisis?
International companies have joined forces to help produce ventilators to fill the severe shortage, and to help people living with HIV survive.

For example, Ford Motor Company said on Monday that it will produce fifty thousand artificial respirators during the next hundred days at a factory in Michigan in cooperation with the health care unit at General Electric.

Ford said that the simplified design of the ventilator can meet the needs of most Covid-19 patients and depends on air pressure without the need for electricity.

General Motors said it plans to produce up to 10,000 respirators every month by this summer at a plant in Kokomo, Indiana.

"With the epidemic in the world, there is an unprecedented demand for medical equipment, including ventilators," said Kiran Murphy, head of "GE Healthcare", "Kiran Murphy."

French company Air Liquide plans to increase the production of respirators from 500 units per month to 1,100 in April.

And the company "Drieger", the medical technology giant in Germany that it has doubled the number of ventilators produced, while "Leuvenstein" obtained a government order includes 6500 units during the next three months.

It started to increase production in February due to high demand for these devices from China.

In America, the US Department of Defense's Supply and Supply Authority contracted with four entities to purchase 8,000 respirators, to deal with the increasing numbers of people living with the Coronavirus.

On Saturday, Bloomberg News quoted US Department of Defense spokesman Lieutenant-Colonel Air Force Mike Andrews as saying that the purchase will take place in stages over the coming months.

The agency said that the cost of those devices amounted to 84.4 million dollars, and the first batch of 1400 devices will be delivered by early May.

10- Are there experiments on new devices?
There are experiments in Britain on a new model of respirators developed by a team in which Mercedes is involved and that can help patients with Coronavirus and is currently being tested in some London hospitals.

CPA devices were used in China and Italy to deliver air and oxygen to patients ’lungs and help them breathe without the need to place them on ventilators, which represent stronger medical intervention.

The supervisory authority has already approved CBEB devices, and 100 of them will be handed over to University College Hospital in London for trial before being distributed to other hospitals.

Reports from Italy indicate that approximately 50% of patients who were placed on CPAP devices did not need ventilators that require patient anesthesia, which allowed these vital devices to others who were in greatest need.

"Mercedes can manufacture 1,000 devices within a week, and if the experiments go well, the NHS can get it by the end of the week," said Rebecca Shipley, director of the Institute of Health Care Engineering of the University College Hospital, told the BBC. .