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COVID-19 is a respiratory disease characterized by a dry cough, sore throat, fever, body aches, general body weakness, and, in extreme cases, acute pneumonia that causes difficulty in breathing. This disease is caused by a virus called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), which is a new virus strain that had previously not been experienced in humans.
The first COVID-19 case was reported in Wuhan, China, in 2019. This viral infection mainly affects the lungs. The virus settles on the mucus membranes in the eyes, nose, and throat, where it multiplies exponentially and ultimately causes the disease. Patients who contract this virus respond differently to it, with some experiencing mild flu-like symptoms. In contrast, others develop severe lung damage that makes it difficult and sometimes impossible for them to breathe on their own.
COVID-19 is a disease that spreads quite fast, and it is transmitted from person to person. If a healthy person comes into contact with an infected person’s body or used items such as spoons, cups, and clothing such as handkerchiefs, the likelihood of infection is high. The virus stays in the body for anything between 2-14 days before the infected persons begin to show symptoms.
This particular disease affects everyone across age, gender, and even race divide. However, it poses a larger threat to patients that have one form of underlying conditions or other. Patients that have diabetes, hypertension, liver disease, renal complications, low immunity, and other pre-existing conditions and those advanced in age tend to exhibit extreme symptoms, and some even experience respiratory failure.
There is still no known treatment for this disease, and doctors and scientists are working round the clock to find a vaccine for it. When a patient is admitted to the hospital, doctors deal with their conditions by trying to handle the symptoms as opposed to treating disease. Doctors use ventilators to help those who have difficulty in breathing.
Ventilators: What are they?
A ventilator is a medical piece of equipment used to assist patients who cannot breathe on their get breathable air in and out of their lungs mechanically. A ventilator is a combination of several pieces of equipment that work together to compress air and channel it in and out of a patient’s lungs.
What are the main components of a ventilator?
This machine is divided into four main parts. They are;
- Power source
- The gas delivery control system
- Monitoring devices
- Safety features
Each of these parts performs a specific set of functions. Let’s dive into each one.
This mainly supplies the ventilator with the energy it needs to run. The power generated into the ventilator is used to supply the gas from the machine to the patient’s lungs. There is also a system of batteries that help in energy circulation and delivery to the various ventilator parts.
Gas Delivery Control System
The control system regulates the timing of gas delivery into the lungs and the specifications of the gas needed. The control system is a combination of several parts that work separately for optimum gas delivery. These parts include;
A gas blender
This device is charged with mixing the gases used to match the patient’s needs. For instance, some forms of anesthesia are delivered to a patient’s body by way of inhalation. A gas blender mixes the anesthesia with breathable oxygen since the drug cannot be inhaled on its own. This part is not found in all ventilators since some are of old technology and only use room air.
The gas accumulator acts as a reservoir for blended gas. It is important since it helps in the mixing and storage of gases that require extreme precision and that are used in little amounts. It is better suited to handle gases that have a low rate of flow and therefore, cannot be handled by the proportioning valves.
This part of the equipment works by heating air to vaporize it, adding humidity into the breathable air. Ventilators that do not have this component and that deliver gas through a face mask rely on the patient’s airway for humidity. There are two types of humidifying equipment, the active humidifier, and the passive humidifier. Active humidifiers vaporize water into the gas as in the above instance, while passive humidifiers are detached from external energy sources and act as moisture and heat exchangers.
Inspiratory Flow Regulator
This piece of equipment ensures that gas from the ventilator is delivered to the patient in the right amounts and pressure. The recommended pressure is 400kPa. The regulator is usually an adjustable valve.
This is corrugated tubing that delivers oxygen and anesthesia to the patient and acts as a conduit for removing carbon dioxide and directing it away from the patient’s lungs.
The Expiratory Pressure Regulator
The Positive End Expiratory Pressure (PEEP) regulator maintains and controls the pressure in the patient’s airway. It allows for the level of oxygen being administered to be regulated for optimal gas exchange.
These devices use several parameters to ensure that a ventilator is working as it should and that the patient is receiving the right concentration and volume of gas at the required pressure level. The use of sensors achieves this. The following parameters are subject to monitoring;
In modern ventilators, this parameter is not directly measured. It is quantified against flow measurements.
Flow indicates the measure of air leaving the ventilator into a patient’s lungs and is measured by volume per unit time (cubic feet per minute – CFM). This parameter is measured using several means outlined below.
- Variable orifice flowmeters – Calculates flow by detecting and measuring the pressure drop across a narrow pipe.
- Hotwire anemometry – Measures the velocity and direction of gas flow
- Screen pneumotachograph – Measures pressure drop across a mesh screen
- Ultrasonic flowmeters – Incorporate the use of sound waves to measure the velocity of the gas flowing in a pipe.
This measures the correlation between volume and compliance.
Spectrophotometers and voltaic cells measure the concentration of gas delivered by the ventilator.
There are devices admeasures that ensure that a patient on a ventilator does not sustain any injury or stress from the manual ventilator action. They include;
The purpose of filters ensures that no foreign bodies get into the ventilator and lungs. Inspiratory filters facilitate the purity of gas to be inhaled. It is rid of foreign objects and pathogens that could cause infections in the patient’s lungs and other body parts.
Expiratory filters essentially act as protection for hospital staff and patient caregivers. The exhaled air is cleaned to ensure that no pathogens from the patient’s lungs are introduced into the ambient air.
These devices are connected to the ventilator software and ensure that all parts and parameters of the equipment work as they should. They operate in line with the keyed in measures decided upon by a patient’s doctor or nurse. They will give off audible alarm sound if the measures change unexpectedly or if the patient experience a form of respiratory distress.
What are the two main types of ventilators?
These machines are classified based on their mode of air delivery into the lungs. There are invasive and non-invasive mechanical ventilators. Invasive ventilators work by inserting a person’s trachea through the mouth. These ventilators can only be used in a hospital’s Intensive Care Unit. Non-invasive ventilators do not require a tube to be inserted into the windpipe and can be used from the comfort of the home.
Their mode of pressure ventilation further classifies ventilators. They are Positive-Pressure Ventilation and Negative-Pressure Ventilation.
Positive-pressure ventilation works by pushing air into the lungs of the patient.
Negative-pressure ventilation causes the chest cavity to expand and contract, sucking the air into the lungs.
Why is ventilator important?
As earlier mentioned, a ventilator helps patients who are experiencing some form of respiratory trauma that prevents them from breathing properly or from breathing at all. In the case of COVID-19, the coronavirus responsible for the disease enters the body through mucus membranes in the eyes, nose, and throat.
The virus, being a much smaller micro-organism than a cell, penetrates the cell wall and begins to replicate. This way, it takes over the victim’s respiratory system and causes severe damage in some cases. Patient x-rays have shown significant deterioration in lung tissue as a result of viral pneumonia contracted on account of the coronavirus.
This damage to the lungs is responsible for the respiratory distress experienced by patients. A ventilator, also commonly known as a respirator, takes over the breathing on behalf of the victim. This piece of equipment channels air in and out of the lungs, enabling gaseous exchange. The patient stays on the ventilator until they recover their ability to breathe independently.
How does ventilator work?
When a patient goes into respiratory distress, a health caregiver such as a doctor inserts an endotracheal tube (ET tube) through the mouth or nose into the trachea/windpipe. The tube is then connected to the ventilator, and a mixture of gas and oxygen is mechanically delivered into the lungs. Apart from delivering this gas, the ET tube allows for medical caregivers to remove mucus from the victim’s trachea.
Positive pressure ventilators push air into the lungs of the patient and are the most commonly used. The ventilator will, in most instances, be set at a constant low pressure. This will ensure that the delicate air sacs retain their elasticity and integrity. These ventilators can be pressure-controlled to conduct air delivery within the limit of air pressure in the trachea, and volume-controlled to deliver air volume that has been pre-set or dual controlled, which takes into account the patient’s volume and pressure needs.
Negative pressure ventilators cause the chest to expand and contract, and they suck air into the lungs. There are two types of these ventilators; Iron Lung and Chest Cuirass. Both use similar principles, but the Cuirass is more modern and smaller than the Iron Lung ventilator.
The Most Important Ventilators for COVID-19 patients. Here is The Top 10 Ventilators Equipment.
This section will review a list of 10 ventilators that can be of great help to COVID-19 victims.
1. Hamilton MR1 ($9,999.00)
HAMILTON MR1 Ventilator is suitable for patients across the age divide. It can be used easily in adults, pediatric, and neonatal patients. The Hamilton MR-1 is magnetic resonance conditioned, meaning that it can be used in the vicinity of an MRI scan.
It also has Adaptive Support Ventilation that protects the patient from sustaining an injury during ventilation. Its non-invasive ventilation is a high performance, and there is a speaking valve for invasive ventilation.
- Easy portability
- The long battery life of up to 9 hours
- Magnetic resonance conditioned
- Available speaking valve for invasive ventilation
- High hazard detection (alarm) system
- High-quality non-invasive ventilation.
2. Hamilton S1 ($4,050.00)
The Hamilton S1 is a highly automated and intelligent ventilator that uses modern technology for optimal service delivery. It can synchronize the patient’s details and needs and self-adjusts accordingly.
It is a touchscreen ventilator and has two modes, the invasive and non-invasive modes. It can be used for adults, children, and infants. Like the Hamilton MR-1, this ventilator has Adaptive Support Ventilation, which ensures the patient does not sustain internal trauma from the invasive ventilation.
- Highly automated
- Intelligent auto-scan
- Easy portability
- Automatic pressure controller
- Easy connection to patient monitors
- Flow sensor for precise measurements
- Not all features are available for all countries in the world.
3. Savina 300 Select ($21,000.00)
This ventilator is an ideal piece to use in the ICU. It uses technology for easy configuration and quick configuration. It also has a trigger response mechanism owing to the presence of a turbine. It has auto-flow that has constant volume ventilation at minimum pressure level.
It is also ideal to use in children. The Savina 300 has a 5-hour battery that makes it easy to use away from an electricity source. It also incorporates a low-pressure oxygen inlet that allows ventilation without a central gas supply.
- Easy to operate
- Has a trigger response mechanism
- Has auto-flow for un-uninterrupted supply
- Does not require a central gas supply
- Its build allows for easy clean and disinfection
- It has a considerably lower battery life than other brands.
4. Savina 300 Classic ($21,000.00)
This ventilator has a standardized interface that makes it easy to use and requires short training to master. It has an intelligent alarm that detects the patient’s distress. The Savina 300 Classic can also be used without gas supply and a direct connection to an electricity source.
It also has an inbuilt turbine that facilitates a high flow rate of 250 liters per minute. It comes with a wide range of modes. A trigger response mechanism enables a patient to have stress-free spontaneous breathing. It also has non-invasive breathing with a fast response to a patient’s efforts to breathe.
- Easy to use and learn
- An intelligent alarm that detects the patient’s distress
- May ventilation modes
- High flow rate
- Independence from gas and electricity
- Shorter battery life than other brands
- Not suitable for neonatal patients
5. Draeger Evita Infinity V500 ($8,999.00)
This ventilator is suitable for use in adults, children, and neonatal patients. It is mobile and does not need to be detached from the patient in case you need to move them. It also has a trolley that can carry oxygen cylinders during transport to avoid interrupting oxygen supply.
The ventilator incorporates technology to transform raw patient data into useful information for efficient monitoring. There is an interface screen that displays instructions for ease of use by technicians.
- It is easy to move
- Suitable for patients of all ages
- Smart pulmonary view for patient’s monitoring
- Accessible instructions on an interface screen
- Scalability. It can be scaled for use in large hospitals or small communities.
- It needs an oxygen cylinder to operate.
6. Oxylog 2000 Plus ($3,500.00)
The Oxylog 2000 Plus is a ventilator built to sustain the most strenuous conditions. It has a range of volume-controlled modes ad also offers support for the invasive and invasive modes. The non-invasive mode gives support for the patient and works efficiently to prevent the use of invasive ventilation as early as possible.
This machine has a large display that indicates all ventilator parameters and patient’s conditions at all times, making it easy to monitor them even in hectic conditions. It is also a compact ventilator that allows you to carry it about easily and has a standby battery that lasts up to 4 hours. It is built with durable material to withstand the harshest conditions.
- Easily portable
- Large display
- Can withstand harsh environments
- Offers great support to the patient and prevents the use of invasive ventilation early
- It has short battery life.
7. Draeger Evita V800 ($12,500.00)
Evita V800 ventilator features a brilliant user interface combined with up-to-date glass touch technology to support intuitive operation. It combines high-performance ventilation with an aesthetic design, enabling quick and efficient operation.
This ventilator has a user-friendly interface that is easy to use, even in highly stressful conditions. You can switch between modes on the touchscreen with the touch of a finger. Instructions are also displayed on the screen. It comes with a gas supply unit and a power supply unit.
It allows bed coupling and is easy to transport. It is ideal for adults, children, and neonates, and has both invasive and non-invasive modes. It also has Auto-flow that allows spontaneous breathing.
- It is built for high-stress areas
- It displays instructions on the screen
- Switching between modes is easy
- Auto-flow assists patients to breathe spontaneously
- Easily portable
8. Philips V680 ($9,500.00)
This ventilator allows you to change from invasive to non-invasive modes without having to change to a different device. It is built to meet the needs of patients with a broad range of needs as it uses Auto-Trak that allows it to adapt to the patient’s specific needs. It is easy to learn and use the machine and prevents your patient from sustaining internal trauma in case of an accident.
- You can switch modes easily
- Adapts to the patient’s needs
- Prevents injury to a patient
- Easy to learn and operate
- Not suitable to neonates
9. Carefusion ReVel ($6,999.00)
CareFusion Revel ventilator is a lightweight machine that allows you to transport your patient for long distances, and it comes with its carrier bag. It is also built to give optimum care even with its size. It is easy to use and guides medical caregivers.
It has a 4-hour battery that ensures continuous movement. It is suitable for people of 5 years and above. It also allows you to monitor blood oxygen concentration and pulse rate.
- Small and lightweight
- Displays instructions
- Easy to move across regions
- Monitors blood oxygen and pulse rate.
- Smaller battery than other brands
10. Carefusion Avea ($2,950.00)
This ventilator brad is designed with neonatal patients in mind. While it offers life support for adults and children as well, this brand is great for babies in the NICU ward. It has a patented 3 stage flow sensor that delivers gas in the precise concentration, volume, and pressure.
It displays five different monitored patient values at any one given time. It also has an easy to use interface and is built to accommodate technological changes.
- It is ideal for neonates
- Has a 3 stage flow sensor for precise gas delivery
- Monitors and displays patient parameters throughout
- Encourages patient-ventilator synchrony
- It is not as portable as other brands
The problem presented by the COVID-19 pandemic was unprecedented and posed a threat to every person in the world. While some patients are not adversely affected by the virus, some face life-threatening situations due to the inability to breathe correctly. This is where ventilators come in handy. There are many brands in the market, and some are more effective than others.
Apart from the cost of the ventilator, the main factors that determine the choice you make are the patient’s needs. A suitable respirator does not just pump air into the victim’s lungs; it also studies and monitors their physiological conditions and prompts them to try and breathe on their own.