Scientific study suggests that mechanical ventilation may aggravate the condition of COVID patients

A scientific study by Tulane University warned that the use of mechanical ventilation in patients with Acute Respiratory Distress Syndrome (ARDS) can aggravate the condition, causing lung injuries that contribute to a mortality rate of 30-40% of treated patients. According to this report, many of the patients most affected by COVID during the pandemic may have been harmed by the absence of an alternative treatment to the use of ventilators to assist breathing.

The study, published in Proceedings of the National Academy of Sciences (PNAS), was conducted by renowned experts in various healthcare fields and several universities, including biomedical engineers, surgeons and doctors such as Donald P. Gaver III, Gary Nieman, Joshua Satalin and Nader Habashi.

'Small explosions' that can cause microscopic damage

The researchers decided to initiate the study since "the progression of acute respiratory distress syndrome from onset due to illness or trauma to recovery or death is not well understood. At present, there are no generally accepted treatments other than supportive care by mechanical ventilation. However, this can lead to mechanical ventilation-induced lung injury (MIVI), which contributes to a mortality rate of 30-40%."

In fact, experiments conducted by the scientific team suggest that repeated collapse and reopening of the alveoli (tiny air sacs of the lungs) create intense microscopic stress, resembling "small explosions," which may end up causing microscopic damage to tissues during mechanical ventilation. These injuries could play a key role with mechanical ventilation-related injuries, which cause thousands of deaths annually.

According to the researchers, the process called alveolar recruitment and derecruitment (when alveoli repeatedly collapse and reopen) accounts for only 2-5% of the total energy used during ventilation. However, this small percentage is directly related to lung injury in cases of Acute Respiratory Distress Syndrome.

'Minimizing repetitive cycles of collapse and reopening' of the alveoli

In the words of lead researcher Donald P. Gaver, professor of biomedical engineering at Tulane University's College of Science and Engineering, "It's like a small explosion on the delicate lung surface. Although small in magnitude, it creates a power intensity of about 100 watts per square meter, comparable to exposure to sunlight."

This finding led the scientists to suggest that "minimizing these repetitive cycles of collapse and reopening could significantly reduce ventilation-induced lung injury" and that "adjusting ventilation strategies to prevent such events could improve outcomes for critically ill patients."

Gaver noted that the future of assisted ventilation involves "including the development of real-time monitoring devices to quantify reopening events and integrating these data into treatment strategies to optimize ventilation and improve patient outcomes."