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Your Healthy Family: The role ventilators are playing in the COVID-19 pandemic

Posted at 9:47 AM, Apr 14, 2020
and last updated 2020-04-14 11:47:49-04

COLORADO SPRINGS — Large numbers of patients with COVID-19 infections need ICU care, and nearly 40% of those admitted need ventilators. This makes the medical device one of the most critical needs for hospitals. UCHealth hospitals currently have adequate numbers of ventilators to care for patients, but the health system is actively working to acquire more units.

Ventilators have been crucial during the COVID-19 pandemic because some patients quickly decline and go into respiratory distress.

“The majority of the patients that have COVID-19 and require mechanical ventilation support have a condition referred to as Adult Respiratory Distress Syndrome, or ARDS,” said Kevin McQueen, who is UCHealth’s lead respiratory director. McQueen is also the president-elect for the Colorado Society for Respiratory Care.

“The condition makes it difficult for individuals to breathe on their own or get enough oxygen. A breathing tube is inserted into a patient’s airway and they are placed on a ventilator to support their breathing, with the goal of providing support until they are able to breathe adequately on their own.”

Ventilators, McQueen explained, provide positive pressure and push air into the lungs; people normally breathe with negative pressure when inhaling. The ventilator will essentially inhale and exhale for a patient and help work with all of the gas exchange that needs to happen in the lungs.

There are many different kinds of ventilators, with the type used being dependent on the level of support each patient needs – basically how sick they are.

“Mechanical ventilators are extremely complex,” said McQueen. “It takes a lot of training and education to be able to manage them. Respiratory therapists go through extensive training - multiple years of schooling. When it comes to mechanical ventilation, probably the most important person at the bedside is the respiratory therapist. We work alongside the nurses, and the critical care physicians and the anesthesiologists to really manage the ventilators.”

Proning – placing ventilated patients on their stomachs – has also been shown to be beneficial for patients with COVID-19. “Most patients in hospital beds lie on their back with the head of the bed tilted lightly upward. Proning is when we place patients face down, flat on their beds in an effort to increase ventilation to the largest sections of the lungs. Proning may require the individual to be face down for 12-16 hours per day,” McQueen explained.

Patients with COVID-19 are staying on ventilators much longer than other patients who may need the help of a ventilator, McQueen added. “The average is 11-12 days longer,” McQueen said. Some of the risks of being on so long is that it puts the body through a tremendous amount of stress. Lying in bed and being sedated that long is very hard on your body: You lose a lot of muscle mass and it takes longer to recover.”

McQueen said teams of people at UCHealth are working with commercial suppliers, the state of Colorado and others to bring more of these life-saving devices to our state to plan for any potential surge in patients.

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