How intelligent ventilators can address India’s critical healthcare shortages

Kaouther Saihi | Updated on June 17, 2021

Intelligent ventilators provide valuable support to healthcare workers by providing them with constantly updated information about the patient’s health status

Healthcare providers across the nation are seeing their infrastructure become rapidly overwhelmed amidst the tumult of the Covid-19 induced pandemic. The scarcity of resources has affected medical facilities even at the regional level, causing spikes in mortality rates. Today, ventilators have become pivotal tools in providing life-sustaining treatment and representing the final life-saving intervention. They can increase the potential for a patient’s recovery by offering vital respiratory support.

At this decisive stage of life and death, every breath and every second counts. Each individual step taken by a caregiver becomes a determinant of the patient’s survival. Great care must be taken when adjusting controls on a typical ventilator to provide the right respiratory support to a patient, so as not to overwork their already stressed organs. Intelligent ventilators, are able to serve as the ideal “bedside assistants”, as they are equipped to adjust continuously without any manual intervention and apply the right level of ventilation for each individual patient. They help strike a balance between too little respiratory support and too much support from the ventilator that may lead to lung injury.

At this critical stage, intelligent ventilators therefore can provide valuable support to healthcare workers by providing them with constantly updated information about the patient’s health status. The advanced technology can not only provide safe and effective treatment for critically ill patients, but also help relieve the caregivers’ workload. This becomes twice as important during a pandemic, where healthcare staff are overloaded by the number of patients needing simultaneous care and very little time remains for personalised attention

Bedside assistants

Some intelligent ventilators are equipped with the advanced ventilation mode. Using physiologic data from the patient and targets set by the clinician, the ventilator regulates the patient’s CO2 elimination and oxygenation. It constantly monitors the patient, whether they are completely dependent on the ventilator or able to draw some breaths themselves, from the time they are intubated right through to extubation.

Regardless of the patient’s condition or the severity of their illness, a ventilator with the advanced mode adjusts to the individual lung mechanics and selects safe, appropriate levels of volume of air and oxygen delivered to the lung, called tidal volume, driving pressure, and mechanical power. If necessary, caregivers can also set limits depending on the patient’s clinical condition. With this continuous adjustment according to the patient’s lung condition, intelligent ventilators represent a step away from the “one size fits all” approach, where values for certain parameters are used across the board as thumb-rules for most patients on ventilation.

Intelligent ventilators are also able to automate the process of taking the patient off the ventilator’s support, referred as weaning. Up until now, weaning is a task that has been manually controlled.

Some medical research showed that intelligent ventilation systems can deliver safe and efficient ventilatory support with a minimum of human supervision. This means that caregivers can focus on other tasks needed to keep a patient alive in an intensive care unit. The caregiver is upgraded to a supervisor rather than a knob turner, freed from the task of frequently checking the ventilator and adjusting the settings.

Helping India plug the gaps

According to the Economic Survey 2019-20, India’s doctor-to-population ratio is at a startling 1:1456. This is in stark contrast to the World Health Organization’s recommended ratio of 1:1000. The situation is even more alarming when it comes to critical care specialists and nurses. At a time when healthcare workers across the country are overworked and overburdened, intelligent ventilators help free up their valuable time and let them focus on other tasks in the ICU.

This aspect is crucial, as simultaneously tending to a large number of patients can often lead to poor quality of care and stress-related burnout. The adoption of intelligent ventilators can drastically reduce this burden and allow for optimal usage of human resources. At the same time, the need for less supervision of the ventilator by the healthcare workers drastically decreases their risk of contamination from Covid-19 patients.

In addition, intelligent ventilators do not necessarily require a high level of expert knowledge. Healthcare workers with less training are still able to operate the simplified settings. This is particularly significant in the Indian context, where the availability of qualified and trained personnel for operating critical care devices may be limited. It can also help bridge India’s wide urban-rural healthcare infrastructure gap, which has limited quality medical treatment to bubbles of the population.

The use of smart sensors and monitoring tools that constantly check whether the patient is ready to wean off the ventilator and then initiate the process automatically also help promote early weaning. This can therefore reduce the duration of mechanical ventilation. According to some studies, this shortened ventilation time leads to reduced use of sedatives, lower morbidity and mortality. All of these factors can contribute to reducing the cost of the therapy.

While the benefits of using intelligent ventilators during a pandemic are many and wide-ranging, their application in critical healthcare therefore goes beyond just tiding healthcare facilities over during this time. The pandemic has certainly served as a rude wake-up call by revealing the vulnerabilities of our healthcare system in such a crisis, but it has also laid bare the huge infrastructure gap that needs to be plugged for future readiness. An obvious solution lies in the adoption of smart technology that can help us get through similar health crises in the future. Intelligent ventilation systems can play an important role in ensuring the safe and effective treatment of patients, even when the system is under great strain.

The writer is Product Manager - Intelligent Solutions, Hamilton Medical, Switzerland

Published on June 17, 2021

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