Ventilator: an ATM machine or a boon: a neurosurgeon’s perspective

In the post-covid era, the awareness regarding ICU care and ventilators has drastically increased, unfortunately, and lately, a common man has also developed a darker perspective about the same. High cost of treatment bills, lack of trust in doctors and hospitals keeping patients on ventilators, and loss of kin on ventilators have caused resentment amongst all strata of society. So, is it true that ventilators are just tools to delay death? Increase revenue and your bills? Is it true that we use ventilators even on a conscious or borderline comatose patient without true indication just to prolong stay? is it true that if a patient is on a ventilator, he will not improve? Not at all. Well, I am not an Intensivist, but I would like to address these misconceptions from a neurosurgeon’s perspective for a common man.

Mechanical Ventilators, invented gradually from crude ideas in 1928 to “bird’s universal medical respirator” by Forest bird in 1955 have technologically evolved now into “Wonder-Machines” in the present scenario and they have improved the patient outcome significantly. Playing a vital role in ensuring adequate delivery of oxygen to body organs, and washing out carbon dioxide from the lungs, assisting the function of the lungs. In neurosciences, we say “time is brain”, which means the more we deprive the brain of oxygenation and perfusion, the more we lose the brain tissue permanently, that’s where these ventilators come into the picture. In the majority of the complex brain problems starting from stroke, head injury, brain tumors with brain swelling, to postoperative care of neurosurgery, the Judicious use of Ventilators has done magical work and saved a lot of patients.

Surprisingly, there are many instances when we have to use ventilators even for drowsy/confused but conscious patients with increased intracranial pressure or swelling in the brain, and we have required these machines to ventilate the brain tissues for days, to a layman, it appears that doctors or hospitals are increasing the stay in ICU on ventilators and just increasing the bill amount, but that is not the case actually, and we have saved many patients with such “elective ventilator support”. To add to it, unlike a common misconception - a falling oxygen level (low spo2) is not the only indication for a ventilator, ventilator has a lot of other indications and when used judiciously by doctors it can do wonders. A lot of patients get weaned off the ventilator, so the misconception that “once on the ventilator, the patient is not going to come back” is false, and hopeless. we believe in Hope, we(Doctors) believe in fighting till the last moment and because of this positive attitude, many patients get out of ventilators and walk home alive.

Healthcare has evolved in our country and specialties like neurosurgery too. Indian doctors and healthcare systems are one of the best in class in the world, this reflects a significant increase in life expectancy and reduced deaths in our country. therefore, rather than doubting the doctors and healthcare system, I intend to instill hope in our system and understand the real perspective and importance of ICU care and Ventilators, in this case from a neurosurgeon’s perspective.

#Trustyourdoctor.#indiandoctors

Thank you.

Dr. Parth Jani( Consultant Neurosurgeon,

HCG Hospital, Ahmedabad,

Gujarat-ph. 8866449844 )