• Published on: Apr 05, 2020
  • 3 minute read
  • By: Dr Rajan Choudhary

Ventilators, When Breathing Is Not Enough For Covid-19 Patients!

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Ventilators. A device few had heard of before the pandemic.

This life saving machine is desperately sought after by hospitals around the world. COVID patients with the most severe symptoms require ventilator support to survive and recover. But what is this machine? And what does it actually do?

THE BASICS

Breathing is a simple task, one that we do not think about. When we breathe our chest expands, and air is pulled into our lungs. Here oxygen is exchanged into the blood and transported by the pumping heart throughout the body. In our cells the oxygen is used to release energy from our food, and drive every process and reaction that keeps us alive and functioning.

COVID-19 is a respiratory disease caused by the coronavirus. Its symptoms include a dry cough, fever, feeling tired and more. In most patients the disease is mild. However some suffer from severe disease, causing havoc in their lungs. It can cause viral pneumonia in both of the patients lungs, which reduces the amount of lung able to bring in oxygen to the lung. The patient’s respiratory rate increases, as they struggle to draw in oxygen.

If a person is struggling to breathe on room air doctors can provide them extra oxygen. This is given through a mask they wear on their face. Normal air only has 21% oxygen, but in hospitals it is possible to give air that is 100% oxygen. This means more oxygen reaches the blood, and the patient has to put in less effort to breathe to get the same amount of oxygen to their cells.

In severe cases it can cause widespread inflammation in the lungs, causing fluid to build up and making breathing harder and more laborious. The patient can become tired having to breathe quicker and harder, and this is when doctors look to intensive care specialists and ventilator support.

VENTILATION

If a person is unable to breathe for themselves, it is possible to do this manually or mechanically. Specialists can insert a tube into the mouth of an unconscious patient that enters their windpipe. A bag pump can be attached to this, which a doctor can squeeze to push air into the patient’s lungs. But a person cannot continuously squeeze this bag to keep ventilating someone, as this is time consuming and tiring.

Ventilators are composed of a compressible reservoir or turbine that can push air into the patients lungs. Unlike regular pumps that continuously push air or water, ventilators have to mimic how we breathe. We inspire air in, then expire air out. Ventilators achieve this by pushing in air for a few seconds, inflating the lungs, then releasing the pressure. The natural elasticity of the patients ribs and lungs squeezes the excess air out, mimicking exhalation.

Modern ventilators are very smart, and have many configurable settings. They can be set to deliver defined quantities of air, change the rate of breathing and other advanced settings.

Hospitals regularly use ventilators for patients who are struggling to breathe, patients who are in a coma and have lost the ability to breathe, and also for anaesthetised patients in operating theatres. During the pandemic hospitals are cancelling unnecessary or non-emergency operations, redistributing these ventilators to be used for COVID patients instead.

MAKE MORE VENTS

It is estimated that up to 30% of patients that are admitted to hospital require ventilators. Most hospitals across the world do not have enough ventilators because they have never needed to ventilate so many patients. Governments have recruited the help of manufacturing companies to ramp up production of ventilators. In the UK F1 teams, military aircraft constructors and hoover manufacturers have all taken up the challenge and repurposed their factories.

There have also been innovations to create new ventilator designs that are cheap and easy to produce. This often involves off-the-shelf equipment that is already present in hospitals, and 3D printed parts. Such machines often do not require electricity or circuit board electronics, and can even be powered by the high pressure oxygen flowing from gas canisters or hospital walls.

- University College Dublin: https://techcrunch.com/2020/03/19/open-source-project-spins-up-3d-printed-ventilator-validation-prototype-in-just-one-week/ ventilator prototype

- University of Oxford: http://www.ox.ac.uk/news/2020-03-31-ventilator-project-oxvent-gets-green-light-uk-government-proceed-next-stage-testing Ventilator project

NEVER A SIMPLE SOLUTION

But as always its not always this simple. Ventilators are complex machines requiring specialist training to function and maintain, as ventilation and respiratory physiology is quite complicated. Ventilators will be of limited use if hospitals do not have enough staff trained to use them safely.

Ventilators are not without risk either. Because they push air into the lung, continuous use, excessive pressures and improper use can cause some damage to the delicate anatomy inside the lung, causing problems in itself. The plastic tube can also be a source of infection. Some hospitals that have had a sharp increase in ventilated patients have encountered problems supplying all their patients with pressurised oxygen. The patient load is overwhelming their infrastructure.

Unfortunately like most things in medicine, ventilators are not a magic cure. Due to the shortage of ventilators not everyone who needs one is able to get it. Most patients who end up needing ventilation are severely ill. The longer a person is on a ventilator the less likely they are to survive. This means that current mortality is rather high.

As more ventilators become available this treatment may become available to those with less severe symptoms, who are more likely to survive especially with this extra help. It is difficult to make these predictions because so many different variables can have an effect. For now we will have to wait and see.

WHAT DOES IT MEAN FOR ME?

The best way to help in these situations is by not catching the virus. This is especially true for those who are elderly, have diabetes, cardiovascular issues or lung diseases. These high-risk patients are more likely to have more serious symptoms, requiring hospitalization. This is why so many countries have enforced lockdown measures. The fewer that are infected, the fewer that need ventilation.

If you do need to leave the house, always follow the following procedures:

- Wash your hands regularly for 20 seconds with soap or alcohol

- Wear a mask outside: This is now official WHO policy

- If you need to cough or sneeze do so into your arm or a tissue

- Only leave the house for essential activities, shopping or to visit the doctor.

Dr Rajan Choudhary, Chief Product Officer & President, Second Medic UK

www.secondmedic.com

Read Blog
Vitamin D

Vitamin D Deficiency Symptoms: Signs Your Body May Be Lacking Vitamin D

Vitamin D is an essential nutrient that plays a vital role in maintaining strong bones, supporting the immune system and regulating several important functions in the body. Despite its importance, vitamin D deficiency is one of the most common nutritional deficiencies worldwide.

In India, vitamin D deficiency has become increasingly prevalent due to lifestyle factors such as limited sunlight exposure, indoor working environments and dietary habits. According to the Indian Council of Medical Research (ICMR), a significant percentage of the population may have insufficient vitamin D levels.

Recognizing the symptoms of vitamin D deficiency early is important because prolonged deficiency can lead to serious health complications affecting bones, muscles and overall wellbeing.

What Is Vitamin D and Why Is It Important?

Vitamin D is often called the “sunshine vitamin” because the body produces it when the skin is exposed to sunlight. It plays a key role in calcium absorption, which is essential for maintaining healthy bones and teeth.

In addition to bone health, vitamin D supports several important functions including:

immune system regulation
muscle function
inflammation control
hormonal balance

Low levels of vitamin D can disrupt these functions and contribute to various health problems.

Common Symptoms of Vitamin D Deficiency

Vitamin D deficiency can manifest through several symptoms, many of which are often overlooked or mistaken for other health issues.

Persistent Fatigue

Constant tiredness or low energy levels may be one of the earliest signs of vitamin D deficiency. Even after adequate rest, individuals with low vitamin D levels may continue to feel exhausted.

Vitamin D plays a role in cellular energy production, and insufficient levels may contribute to chronic fatigue.

Bone and Back Pain

One of the most well-known effects of vitamin D deficiency is bone discomfort. Vitamin D helps the body absorb calcium, which is essential for maintaining bone strength.

Low vitamin D levels may cause:

bone pain
lower back pain
increased risk of fractures

Persistent bone discomfort should be evaluated by a healthcare professional.

Muscle Weakness

Vitamin D is important for muscle health and function. Deficiency can lead to muscle weakness, cramps or general muscle fatigue.

Older adults with vitamin D deficiency may also experience reduced mobility and increased risk of falls.

Frequent Illness or Infections

Vitamin D plays a key role in supporting the immune system. Individuals with low vitamin D levels may experience frequent colds, infections or slower recovery from illness.

Research suggests that adequate vitamin D levels help strengthen immune defenses against respiratory infections.

Mood Changes and Depression

Vitamin D may influence brain function and mood regulation. Some studies have found a connection between low vitamin D levels and mood disorders such as depression or anxiety.

People experiencing persistent mood changes should consider evaluating vitamin levels as part of a broader health assessment.

Hair Loss

Severe vitamin D deficiency may contribute to hair thinning or hair loss. While hair loss can have multiple causes, nutritional deficiencies including vitamin D deficiency may play a role.

Slow Wound Healing

Vitamin D contributes to the body’s inflammatory response and tissue repair processes. Individuals with deficiency may notice slower wound healing or delayed recovery from injuries.

Who Is at Risk of Vitamin D Deficiency?

Several factors can increase the risk of vitamin D deficiency.

Limited Sun Exposure

People who spend most of their time indoors or use strong sun protection regularly may not receive enough sunlight to produce sufficient vitamin D.

Urban lifestyles and indoor work environments contribute to this problem.

Older Adults

As people age, the skin becomes less efficient at producing vitamin D from sunlight. Older adults may therefore require additional dietary intake or supplements.

Individuals with Darker Skin

Melanin reduces the skin’s ability to produce vitamin D from sunlight. Individuals with darker skin tones may require longer sun exposure to produce adequate levels.

Poor Dietary Intake

Few foods naturally contain vitamin D. Diets lacking fortified foods, dairy products or fatty fish may contribute to deficiency.

Medical Conditions

Certain medical conditions such as kidney disease, liver disease or digestive disorders can affect vitamin D absorption and metabolism.

How Is Vitamin D Deficiency Diagnosed?

Vitamin D deficiency is diagnosed through a simple blood test that measures the level of 25-hydroxyvitamin D in the bloodstream.

Doctors may recommend testing for individuals who experience symptoms of deficiency or belong to high-risk groups.

Early diagnosis allows healthcare providers to recommend appropriate treatment and lifestyle adjustments.

How to Improve Vitamin D Levels

Sunlight Exposure

Regular sunlight exposure is one of the most effective ways to increase vitamin D levels. Experts generally recommend 10 to 30 minutes of sunlight exposure several times per week, depending on skin type and location.

Dietary Sources of Vitamin D

Although limited, certain foods contain vitamin D, including:

fatty fish such as salmon and mackerel
egg yolks
fortified milk and cereals
mushrooms

Including these foods in the diet can help maintain healthy vitamin D levels.

Vitamin D Supplements

In cases of significant deficiency, doctors may recommend vitamin D supplements. The dosage depends on the individual’s vitamin levels, age and health status.

It is important to take supplements under medical supervision to avoid excessive intake.

Preventing Vitamin D Deficiency

Maintaining adequate vitamin D levels requires a balanced combination of sunlight exposure, proper nutrition and regular health monitoring.

Routine health checkups and vitamin testing can help identify deficiencies early and prevent complications.

Adopting a healthy lifestyle with balanced nutrition and outdoor activity can significantly improve vitamin D status and overall health.

Conclusion

Vitamin D deficiency is a common but often overlooked health concern. Symptoms such as fatigue, bone pain, muscle weakness and frequent infections may indicate low vitamin D levels.

Early detection and proper management are essential to prevent long-term health complications. By ensuring adequate sunlight exposure, maintaining a balanced diet and undergoing regular health checkups, individuals can support healthy vitamin D levels and improve overall wellbeing.

Recognizing the warning signs of vitamin D deficiency and seeking timely medical advice can help protect long-term health and maintain optimal body function.

References

  • Indian Council of Medical Research (ICMR) – Nutritional Deficiency Reports

  • World Health Organization (WHO) – Micronutrient Deficiency Guidelines

  • National Institute of Nutrition (NIN) India – Vitamin D Research Reports

  • Lancet Public Health – Nutritional Health Studies

  • National Institutes of Health (NIH) – Vitamin D Fact Sheets for Health Professionals

See all

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