TY - JOUR
T1 - The US Strategic National Stockpile Ventilators in Coronavirus Disease 2019
T2 - A Comparison of Functionality and Analysis Regarding the Emergency Purchase of 200,000 Devices
AU - Branson, Rich
AU - Dichter, Jeffrey R.
AU - Feldman, Henry
AU - Devereaux, Asha
AU - Dries, David
AU - Benditt, Joshua
AU - Hossain, Tanzib
AU - Ghazipura, Marya
AU - King, Mary
AU - Baldisseri, Marie
AU - Christian, Michael D.
AU - Domingiuez-Cherit, Guillermo
AU - Henry, Kiersten
AU - Martland, Anne Marie O.
AU - Huffines, Meredith
AU - Ornoff, Doug
AU - Persoff, Jason
AU - Rodriquez, Dario
AU - Maves, Ryan C.
AU - Kissoon, Niranjan “Tex”
AU - Rubinson, Lewis
N1 - Publisher Copyright:
© 2020 American College of Chest Physicians
PY - 2021/2
Y1 - 2021/2
N2 - Background: Early in the coronavirus disease 2019 (COVID-19) pandemic, there was serious concern that the United States would encounter a shortfall of mechanical ventilators. In response, the US government, using the Defense Production Act, ordered the development of 200,000 ventilators from 11 different manufacturers. These ventilators have different capabilities, and whether all are able to support COVID-19 patients is not evident. Research Question: Evaluate ventilator requirements for affected COVID-19 patients, assess the clinical performance of current US Strategic National Stockpile (SNS) ventilators employed during the pandemic, and finally, compare ordered ventilators’ functionality based on COVID-19 patient needs. Study Design and Methods: Current published literature, publicly available documents, and lay press articles were reviewed by a diverse team of disaster experts. Data were assembled into tabular format, which formed the basis for analysis and future recommendations. Results: COVID-19 patients often develop severe hypoxemic acute respiratory failure and adult respiratory defense syndrome (ARDS), requiring high levels of ventilator support. Current SNS ventilators were unable to fully support all COVID-19 patients, and only approximately half of newly ordered ventilators have the capacity to support the most severely affected patients; ventilators with less capacity for providing high-level support are still of significant value in caring for many patients. Interpretation: Current SNS ventilators and those on order are capable of supporting most but not all COVID-19 patients. Technologic, logistic, and educational challenges encountered from current SNS ventilators are summarized, with potential next-generation SNS ventilator updates offered.
AB - Background: Early in the coronavirus disease 2019 (COVID-19) pandemic, there was serious concern that the United States would encounter a shortfall of mechanical ventilators. In response, the US government, using the Defense Production Act, ordered the development of 200,000 ventilators from 11 different manufacturers. These ventilators have different capabilities, and whether all are able to support COVID-19 patients is not evident. Research Question: Evaluate ventilator requirements for affected COVID-19 patients, assess the clinical performance of current US Strategic National Stockpile (SNS) ventilators employed during the pandemic, and finally, compare ordered ventilators’ functionality based on COVID-19 patient needs. Study Design and Methods: Current published literature, publicly available documents, and lay press articles were reviewed by a diverse team of disaster experts. Data were assembled into tabular format, which formed the basis for analysis and future recommendations. Results: COVID-19 patients often develop severe hypoxemic acute respiratory failure and adult respiratory defense syndrome (ARDS), requiring high levels of ventilator support. Current SNS ventilators were unable to fully support all COVID-19 patients, and only approximately half of newly ordered ventilators have the capacity to support the most severely affected patients; ventilators with less capacity for providing high-level support are still of significant value in caring for many patients. Interpretation: Current SNS ventilators and those on order are capable of supporting most but not all COVID-19 patients. Technologic, logistic, and educational challenges encountered from current SNS ventilators are summarized, with potential next-generation SNS ventilator updates offered.
KW - ARDS
KW - COVID-19
KW - strategic national stockpile
KW - ventilators
UR - http://www.scopus.com/inward/record.url?scp=85099709157&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099709157&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2020.09.085
DO - 10.1016/j.chest.2020.09.085
M3 - Review article
C2 - 32971074
AN - SCOPUS:85099709157
SN - 0012-3692
VL - 159
SP - 634
EP - 652
JO - CHEST
JF - CHEST
IS - 2
ER -