隨著大流行的蔓延，有足夠的呼吸機(jī)嗎?

隨著大流行的蔓延，有足夠的呼吸機(jī)嗎?

As the coronavirus that causes COVID-19 spreads across the United States, there are continuing concerns among hospitals, public health experts and government leaders that hospital intensive care units would be hard-pressed to handle a surge in seriously ill patients.

隨著導(dǎo)致COVID-19的冠狀病毒在美國各地傳播，醫(yī)院、公共衛(wèi)生專家和政府領(lǐng)導(dǎo)人繼續(xù)擔(dān)心，醫(yī)院重癥監(jiān)護(hù)室將難以應(yīng)對重病患者激增。

A key limiting factor to being able to provide good care, they say, is the number of ventilators ，a hospital has on hand to help the most seriously ill patients breathe.

他們說，能夠提供良好護(hù)理的一個(gè)關(guān)鍵限制因素是醫(yī)院現(xiàn)有的呼吸機(jī)的數(shù)量，以幫助病情最嚴(yán)重的病人呼吸。

"The coronavirus, like many respiratory viruses, can cause inflammation in the lungs," explains Dr. William Graham Carlos a pulmonary critical care specialist at Indiana University School of Medicine "And when the lungs become inflamed, the membranes that transfer oxygen from the air into the blood become blocked."

印第安納大學(xué)醫(yī)學(xué)院肺部危重癥護(hù)理專家威廉·格雷厄姆·卡洛斯博士解釋說：“冠狀病毒和許多呼吸道病毒一樣，會(huì)導(dǎo)致肺部發(fā)炎，當(dāng)肺部發(fā)炎時(shí)，將氧氣從空氣中轉(zhuǎn)移到血液中的細(xì)胞膜就會(huì)阻塞。”

When patients develop this type of viral pneumonia, they often require bedside ventilators which, Carlos says "can supply higher levels of oxygen and also help push air into the lungs to open them up, and afford more opportunity to get oxygen into the patient."

當(dāng)病人患上這種病毒性肺炎時(shí)，他們通常需要床邊呼吸機(jī)，卡洛斯說，這“可以提供更高水平的氧氣，也有助于將空氣推進(jìn)肺部，使肺部張開，并為氧氣進(jìn)入病人體內(nèi)提供更多的機(jī)會(huì)。”

Ventilators are generally a temporary bridge to recovery — many patients in critical care who need them do get better. These machines can be crucial to sustaining life in certain emergency situations. And if there is a surge in seriously ill patients, as COVID-19 spreads, ventilators could be in short supply, from hospital to hospital or nationally.

一般來說，呼吸機(jī)是通向康復(fù)的暫時(shí)的橋梁，許多危重病人需要呼吸機(jī)來讓他們的病情有所好轉(zhuǎn)。在某些緊急情況下，這些機(jī)器對維持生命至關(guān)重要。如果隨著COVID-19的傳播，重癥患者數(shù)量激增，那么醫(yī)院間或全國范圍內(nèi)的呼吸機(jī)可能會(huì)出現(xiàn)短缺。

And if there's an increase in very sick patients on a scale like what happened in China, Dr. Eric Toner says, the U.S. is not prepared. Toner studies hospital preparedness for pandemics at the Johns Hopkins Center for Health Security.

埃里克·托納博士說，如果重癥患者的數(shù)量出現(xiàn)了像中國那樣的增長，那么美國還沒有做好準(zhǔn)備。托納在約翰霍普金斯健康安全中心研究醫(yī)院應(yīng)對流行病的預(yù)防工作。

Toner says all hospitals have some lifesaving ventilators, but that number is proportional to the number of hospital beds in the institution. An average-sized hospital with 150 beds, for example, might have 20 ventilators. If more were needed, hospitals that need them could rent them, he says — at least for now.

托納說，所有的醫(yī)院都有一些挽救生命的呼吸機(jī)，但這個(gè)數(shù)字與醫(yī)院的病床數(shù)量成正比。例如，一家擁有150個(gè)床位的中等規(guī)模醫(yī)院可能有20個(gè)呼吸器。如果需要更多，需要的醫(yī)院可以租用，他說，至少現(xiàn)在是這樣。

But if there's a surge of need in a particular community — patients with serious pneumonia from COVID-19 or pneumonia related to flu, for example — all hospitals in the area would be competing to rent from the same place. "So that's a very finite resource" he says.

但是，如果某個(gè)特定社區(qū)的需求激增，例如，COVID-19導(dǎo)致的嚴(yán)重肺炎患者或與流感相關(guān)的肺炎患者該地區(qū)的所有醫(yī)院都將競相從同一個(gè)地方租用。“所以這是一個(gè)非常有限的資源，”他說。

The latest study available estimates there are about 62.000 ventilators in hospitals nationwide. That figure is seven years old — so the actual number could be higher.

最新的研究估計(jì)全國大約有62000名呼吸機(jī)。這個(gè)數(shù)字是7年前的，所以實(shí)際數(shù)字可能更高。

There are also some machines in federally stockpiled emergency supplies, though the exact number isn't public.

聯(lián)邦儲備的緊急物資中也有一些機(jī)器，不過具體數(shù)量還未公開。

"There is a strategic national stockpile of ventilators, but the numbers are classified," says Toner. It's been "publicly stated," he says, that there are about 10.000 ventilators in the national stockpile. "That number might be a bit outdated, but it's probably about right," he says. Other estimates range from 4.000 to somewhat less than 10.000.

托納說：“國家有戰(zhàn)略儲備的呼吸機(jī)，但數(shù)字是保密的。”。他說，據(jù)“公開聲明”說，國家儲備的呼吸機(jī)大約有1萬臺，這個(gè)數(shù)字可能有點(diǎn)過時(shí)，但可能是對的，”他說。其他估計(jì)數(shù)從4000到略低于10000不等。

If there's not enough capacity at one hospital, it may be possible to transfer patients to another, he says.

他說，如果一家醫(yī)院的容量不夠，就有可能把病人轉(zhuǎn)移到另一家醫(yī)院。

"Not every community is going to be hit simultaneously; some cities will be badly affected while others are not so badly affected." So, in some cases, Toner says, it seems likely that patients could be transferred from an area where ventilators are scarce to an area where the supply is adequate.

托納說：“并非每個(gè)社區(qū)都會(huì)同時(shí)受到影響;一些城市會(huì)受到嚴(yán)重影響，而另一些城市則不會(huì)受到如此嚴(yán)重的影響。”因此，在某些情況下，病人可能會(huì)從呼吸機(jī)匱乏的地區(qū)轉(zhuǎn)移到供應(yīng)充足的地區(qū)。

But if hospitals continue to be overwhelmed, he says, at that point, "tough decisions would have to be made about who gets access to a ventilator and who does not."

但他說，如果醫(yī)院仍然人滿為患，到那個(gè)時(shí)候，“就必須做出艱難的決定，決定誰能使用呼吸機(jī)，誰不能。”

All health care providers and hospitals are now working overtime to try to prevent that sort of scenario.

所有的醫(yī)療服務(wù)提供者和醫(yī)院都在加班加點(diǎn)地工作，試圖阻止這種情況的發(fā)生。