“There is a margin of safety”: the chief anesthesiologist-resuscitator of Russia - about the situation with coronavirus and mechanical ventilation machines

- What is the situation with the availability of ventilation devices in Russia at the moment?

- With the artificial respiration apparatus, today everything is in order with us. Moreover, in this matter we have a certain margin of safety thanks to timely organizational decisions. For example, all planned surgical interventions were postponed, and there are a lot of them in Russia. Anesthesia machines, which were used for elective surgery, have now been released as a reserve: with their help, you can also ventilate the lungs and do this for quite a long time.

In the case of coronavirus, we are talking about a short duration of ventilation of the lungs, so no problems with this are expected. In terms of technical equipment, we are advancing ahead of schedule and are ready to answer existing challenges.

- The organization Human Rights Watch announced the purchase by the rich Russians of mechanical ventilation devices, which, because of this, supposedly now may not be enough for ordinary citizens. How reliable is this information?

- This is false and provocative data. What is it that turns out, do these people still buy a whole team of doctors in addition? But without an anesthetist-resuscitator and anesthetist nurse, this technique is useless. And you also need equipment for oxygen supply, for vacuum aspiration, for intubation and re-intubation. In other words, we are talking about the module of the intensive care unit. No, this is absolutely not serious, there’s nothing to talk about.

You don’t have to have a head on your shoulders in order to buy an artificial respiration apparatus that you cannot use.

- At what stage of the disease and how often are ventilation machines used?

- I will explain with an example. Recently, my colleagues and I discussed the option of creating reserve hospitals with 100 beds for the contingent of patients who were accurately diagnosed with the disease. We divided such a hospital into three groups.

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The first is for a typical treatment where oxygen inhalation may be required. The second is for moderate patients who may need non-invasive breathing support (using nasal or facial masks. - RT ). For quite severe cases in which the use of invasive methods is provided, we proactively put 12 beds, that is, approximately 10% of the total number of patients.

- Are there different categories of ventilators?

- Oh sure. Respiratory support can be of various types: from oxygen inhalation through a mask to the most complicated artificial respiration devices, which have dozens of operating modes and require special training from doctors in certified educational institutions.

- Can ventilators be used at home?

- In certain cases, yes, it is possible. There is a category of chronic patients - “lungs”. Even patients in serious condition learned to treat during respiratory support at home. But in cases with viral pneumonia, this is not possible.

- Which scenario will we follow: Italian or Chinese?

- We will be able to avoid a difficult scenario if we go the right way: if we, first of all, focus on prevention and if our people listen to the advice of professionals, and not the false information distributed on the network. In addition, today it is important to take into account the experience that has already been gained in China and Italy.