Should a portable ventilator be used in all in-hospitals?

For multiple hospitalized and bedridden patients, the facility of breathing assistance is considered a lifesaving provision. Diseases such as lung cancer, severe acute bronchitis, pneumonia, COVID-19, and emphysema, among many other diseases conditions, are the states which modify the normal breathing capacity of patients thus rendering them frequently gasping for air. This problem can be solved, although not completely but partially, by the use of ventilators.

 

What is a ventilator?

A ventilator is a machine used to assist the breathing process in patients who are unable to do so naturally. The role of a ventilator can also be explained as an artificial respiratory system that breaths on behalf of the patient in order to keep the subject alive.

 

What are portable ventilators?

In a hospital setting, the movement of a bedridden patient from one ward to another is a routine practice. However, this simple and relatively quick transport can become complicated if the patient is on respiratory assistance as the ventilator cannot be removed even for a shorter period of time, and moving it as a whole from one room to another is a major issue. According to the studies, the transport-related risks during room-to-room shifting exceed 65%. This problem can be solved by the use of portable ventilators.

Portable ventilators are ventilator machines that are smaller in size, lesser in weight, and are easy to be transported from one location to a newer one along with the patient e.g. from ICU to the ward, etc.

Portable ventilator

 

Parts and working process of a portable ventilator

The portable ventilators consist of the following parts:

• Electrical supplies/battery: The portable ventilator requires a battery to run. As the demand for energy is high, the use of nickel-cadmium, nickel metal hydride, and lithium ion-based batteries is a preferred option. In addition to this, the portable ventilators are also adaptable to use the power drawn from the cigarette lighter socket. Furthermore, the DC current supplied by the car battery can also be converted to 24V AC current by the portable ventilator which it can use to run itself. These two options, besides the use of a battery, are particularly helpful while transferring the patient from one hospital to another via an ambulance.

Structure and working of a ventilator

 

• Pneumatic unit: The pneumatic unit is responsible for the supply of a mixture of pressurized air and oxygen gas to the patient via the valves.
• Patient circuits and valves: A breathing circuit is responsible for supplying the oxygen gas to be inhaled. This breathing circuit is fitted with a non-rebreathing valve which provides low resistance to the expired air and thus prevents its trapping into the circuit. In modern portable ventilators, the valves have been replaced by fast-response, brushless-driven turbines which are more efficient in delivering the air mixture.

Types of non-rebreathing valves used with different types of ventilators

 

• Gas supply: The oxygen cylinder is also mandatory to be used in connection with a ventilator. Usually, ambulances carry 1360 liter or 2300 liter oxygen cylinders. These cylinders are affixed with the breathing circuit of the portable ventilators.
• Sensors: The advanced ventilators are equipped with sensors that can detect and adjust the oxygen supply to the patient according to the body’s fluctuating needs.

Mechanical ventilator in working

 

Types of portable ventilators

Portable ventilator machines are of a wide range. The right ventilator can be chosen for a specific patient according to her or his disease condition as well as to the role which is intended to be achieved with the use of a ventilator. The commercially available types of portable ventilators are as follows:

• Portable gas-powered ventilators
• Microprocessor-controlled ventilators

 

Characteristics of portable ventilators

Portable ventilators are respiratory assisting devices that possess the following characteristics:

• Portable ventilators can independently control the tidal volume as well as the frequency of respiratory cycles per minute.
• These ventilators can fully take over the respiratory process thus exempting the patient from the difficulty of actively trying to breathe in oxygen.
• Portable ventilators are able to supply a constant volume of oxygen to the patient over the period of their use.
• These mechanical respiratory assisting devices are also capable of keeping in check the airway pressure.
• The devices are also able to run a disconnect alarm to indicate system failure.

 

Problems associated with the use of portable ventilators

Although the design and marketing of portable ventilators have revolutionized the options for breathing assistance, these devices come with certain side effects as well which are as follows:

• With portable ventilators, a major problem is that their battery life is limited. If the battery dies, the device will stop working thus hindering the process of mechanical breathing.
• Sometimes, the portable ventilators run out of oxygen in them while the device is in use. Care should be practiced in this regard to ensure that the supply of oxygen is not restricted.
• Inadvertent disconnections are also one of the root causes of the failures associated with the employment of portable ventilators.
• Additionally, complications with the use of portable ventilators may also arise due to untrained personnel.

 

Conclusion

Mechanical ventilation is one of the most widely employed methods when it comes to patients with severe respiratory disorders. The need to supply oxygen to the lungs via artificial means is a life-saving activity for many critically ill patients. Simplifying the technique, the use of portable ventilators is a convenient and low-cost way of replicating the natural ventilation process. These ventilators, although come with certain problems which can be resolved by close monitoring of the device when in use, come with several advantages which help the physician to overcome the hurdles in the way of moving the patient from one ward to another. Hence, portable ventilators are one of the dominant inventions in medical science.