What Are Ventilators and Why Are They So Important?

Graham Roeger explains how a ventilator works, and why they are essential when treating hospitalised coronavirus patients.

By Graham Roeger

The urgent need for ventilators due to the Covid-19 pandemic has become an unforgettable plea by leaders worldwide.  Humanity is now acting to combat one of the largest global threats of our lifetime and as the coronavirus continues to spread throughout the world it is evermore apparent that this virus has no bounds.  Geographically, it has infiltrated lands as far flung as the Falkland Islands and the arctic freeze of Greenland, all the while infecting humans regardless of age. Unfortunately, certain age brackets are more susceptible than others to hospitalisation, especially the elderly.  While the medical community has a variety of tools to combat coronavirus, in extreme cases ventilators are often required.  But what exactly are ventilators, why are they important in fighting the coronavirus, and why are older generations more likely to require ventilation?  

Simply speaking, ventilators aid those who cannot breathe, or those who experience difficulties breathing. They do this by artificially pumping breathable air into the patient and removing the spent air in a continuous cycle of respiration.  One of the earliest effective ventilators, colloquially termed the Iron Lung, can be traced back to 1931 when they were used to treat patients with Polio. Thankfully, medicine has advanced past this cumbersome instrument and the ventilator has been transformed into a modernised tool, critical to sustaining lives amongst those with severe pulmonary issues.  With the advent of microprocessors, extremely small computer processing units, the various modes and methods of achieving respiration via a respirator have grown significantly. But why are ventilators so important for coronavirus specifically? 

First let’s cover how our lungs operate.  In essence, when humans breathe in fresh air, oxygen is exchanged for carbon dioxide through small balloon shaped sacs called alveoli deep within our lungs.  It is the alveoli which help facilitate the exact exchange of gasses, though there are still many other vital respiratory features within the human body.   But in regards to the coronavirus, the alveoli are its main target.  When the virus enters the lungs it attaches itself to the alveoli via the spikes of the virus, as often visually depicted, and begins to replicate.  Our bodies respond to the irritated alveoli by coughing in an effort to expel the intruders from within ourselves. While coughing and other immune responses suffice for the majority of Covid-19 cases, in 15-20% of coronavirus cases a “cytokine storm” can occur, often with fatal consequences.

There are still many unanswered questions about the coronavirus, but the medical community is beginning to get an idea of what can trigger a fatal response to the virus.  There are currently several culprits of Covid-19 related fatal respiratory failure, such as acute respiratory distress syndrome and high altitude pulmonary edema. However, cytokine storms are appearing to become one of the more primary causes of death. When infected with coronavirus, a human’s immune system emits cytokine proteins that are designed to fight infections and trigger an inflammatory response in the lungs to expel the virus.  But occasionally something termed a cytokine storm can occur. This is when the body overreacts and emits too many cytokine proteins causing gross inflammation and impairing respiratory functions. Ultimately this inflammation of the lungs can cause respiratory failure and this is when the use of a ventilator steps in.

Anyone who requires hospitalisation due to the coronavirus, young or old, faces a greater chance of death.  However, it is the eldery who are particularly at risk of requiring intensive care. In the United Kingdom, people over the age of 80 are 20 times more likely to require admission to hospitals for the coronavirus than those under the age of 30, and the 80+ age bracket is currently experiencing a mortality rate of roughly 8%.  Older generations are more vulnerable because as the human body ages and cells begin to naturally deteriorate, they are less effective in warding off infections.  Furthermore, people ages 65+ are 6 times more likely than under 45 year olds to develop chronic respiratory illnesses. Sadly, the manner in which coronavirus attacks the lungs, mixed with the natural process of ageing, creates a deadly cocktail for the older members of our community.  Thankfully though, devices such as ventilators can help save lives as humanity pushes through this pandemic.  

While no cure for Covid-19 itself exists, ventilators act to sustain life while medical personnel can further consider treatment options to alleviate patient symptoms.  Ventilators themselves will not bring someone out of death, but the excess time it provides for doctors to treat patients is vital. For the coronavirus pandemic, time matters.  The more time we have, the more lives will be saved. In hospitals, ventilators provide that time, and more patients will be brought home because of them.  

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Graham Roeger explains how a ventilator works, and why they are essential when treating hospitalised coronavirus patients.