随着大流行的蔓延，有足够的呼吸机吗?

随着大流行的蔓延，有足够的呼吸机吗?

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.

随着导致COVID-19的冠状病毒在美国各地传播，医院、公共卫生专家和政府领导人继续担心，医院重症监护室将难以应对重病患者激增。

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.

他们说，能够提供良好护理的一个关键限制因素是医院现有的呼吸机的数量，以帮助病情最严重的病人呼吸。

"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."

印第安纳大学医学院肺部危重症护理专家威廉·格雷厄姆·卡洛斯博士解释说：“冠状病毒和许多呼吸道病毒一样，会导致肺部发炎，当肺部发炎时，将氧气从空气中转移到血液中的细胞膜就会阻塞。”

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."

当病人患上这种病毒性肺炎时，他们通常需要床边呼吸机，卡洛斯说，这“可以提供更高水平的氧气，也有助于将空气推进肺部，使肺部张开，并为氧气进入病人体内提供更多的机会。”

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.

一般来说，呼吸机是通向康复的暂时的桥梁，许多危重病人需要呼吸机来让他们的病情有所好转。在某些紧急情况下，这些机器对维持生命至关重要。如果随着COVID-19的传播，重症患者数量激增，那么医院间或全国范围内的呼吸机可能会出现短缺。

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·托纳博士说，如果重症患者的数量出现了像中国那样的增长，那么美国还没有做好准备。托纳在约翰霍普金斯健康安全中心研究医院应对流行病的预防工作。

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.

托纳说，所有的医院都有一些挽救生命的呼吸机，但这个数字与医院的病床数量成正比。例如，一家拥有150个床位的中等规模医院可能有20个呼吸器。如果需要更多，需要的医院可以租用，他说，至少现在是这样。

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，如果某个特定社区的需求激增，例如，COVID-19导致的严重肺炎患者或与流感相关的肺炎患者该地区的所有医院都将竞相从同一个地方租用。“所以这是一个非常有限的资源，”他说。

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.

最新的研究估计全国大约有62000名呼吸机。这个数字是7年前的，所以实际数字可能更高。

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

联邦储备的紧急物资中也有一些机器，不过具体数量还未公开。

"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.

托纳说：“国家有战略储备的呼吸机，但数字是保密的。”。他说，据“公开声明”说，国家储备的呼吸机大约有1万台，这个数字可能有点过时，但可能是对的，”他说。其他估计数从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.

他说，如果一家医院的容量不够，就有可能把病人转移到另一家医院。

"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.

托纳说：“并非每个社区都会同时受到影响;一些城市会受到严重影响，而另一些城市则不会受到如此严重的影响。”因此，在某些情况下，病人可能会从呼吸机匮乏的地区转移到供应充足的地区。

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."

但他说，如果医院仍然人满为患，到那个时候，“就必须做出艰难的决定，决定谁能使用呼吸机，谁不能。”

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

所有的医疗服务提供者和医院都在加班加点地工作，试图阻止这种情况的发生。