Respiratory support can mean the difference between life and death for Covid-19 patients.
About one in six people who contracts the disease becomes seriously ill and develop difficulty breathing.
While this is most likely the elderly and people with blood pressure, heart or lung problems, or those with diabetes, about half of the patients requiring intensive care unit (ICU) admission in Ireland so far are under 50.
In those scenarios, with no medical cure for coronavirus, the "superheroes in gowns and scrubs" rely on ventilators and other breathing-support systems to help save lives.
Professor John Laffey, of NUI Galway and consultant in anaesthesia and intensive care medicine at Galway University Hospitals, said that when a patient came in with Covid-19, they would have a massive inflammation of the lungs and respiratory failure and, therefore, very low oxygen levels. Respiratory support allows medics to get a supply of oxygen into the lungs, assisting the patient's breathing until they can function normally.
But there may not be enough ventilators to deal with demand. Italian doctor Daniele Macchini said recently: "Every ventilator becomes like gold."
Doctors in some of the worst-affected countries have had to make very difficult decisions about to whom they offer this life-supporting measure.
In Galway, a global hub for medical devices, Prof Laffey is part of a team of academics and industry representatives brainstorming to meet the ventilator challenge, with an idea borrowed from how US hospitals deal with an influx of victims of mass shootings.
The group is led by Professor Martin O'Halloran of the College of Engineering, an award-winning researcher in the area of medical devices.
One key task they have set themselves is getting each ventilator to ventilate two patients at the same time.
"There is a realistic possibility," said Prof Laffey.
The approach has been used in mass casualty situations, such as shootings in the US, where a person has normal lung function.
"Their lungs are OK, so you can split the lines of the ventilator in two," he said.
While this works well temporarily if the patient has normal lung function, it is not that simple when dealing with Covid-19.
"It is not sophisticated enough for people with injured lungs, who may need different levels of breathing support.
"We need to build technology into them. The idea would be to connect two patients with different degrees of lung injury to a single ventilator and regulate what they get independently. This is a very significant engineering and technological challenge, but we are making good progress towards a solution," he said.
The group is also tackling another challenge thrown up by Covid-19, as it develops approaches to minimise the risks to healthcare workers associated with the use of certain forms of non-invasive ventilation.
Non-invasive ventilation, usually involving placing a mask on the face or a device in the nostrils, is used for patients with less severe breathing problems, and can avoid the need for a ventilator.
But with Covid-19 patients, certain non-invasive supports can potentially expose hospital staff to the virus. These are systems that use pressure to push air into patients, generating aerosol mists that may contain virus particles from the patient's breath. These can leak into the atmosphere when, for instance, a mask does not create a seal around the face.
"When someone breathes out, they breathe out moisture particles that potentially contain the virus," said Prof Laffey.
Because of these risks, restrictions are placed on the use of these systems and Prof Laffey said they were seeking to make them safer through finding ways to capture the aerosol.
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