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The number of non-invasive ventilators (NIV) in the country went up more than five times in the last one year, and this could be the reason why there were no high-pitched calls for NIVs unlike oxygen concentrators during the second wave.
“At the beginning of the pandemic last year, all were talking about ventilators, particularly NIVs. Nobody was talking about oxygen at that point in time because there was ample oxygen supply. This time most of news was around oxygen and oxygen concentrators. We did not hear much about NIV because they were in ample supply,” said Sibasish Dey, head of Medical Affairs for Asia and Latin America at ResMed, a world leader in respiratory devices.
Adequate stock
The number of NIVs available in India went up more than five-fold since the beginning of the pandemic last year, he said. Buthe said NIV makers are still getting orders from State governments and hospitals, and that they have adequate stocks.
During the second wave, some States even issued advisories to hospitals, asking them to use NIVs instead of high-flow nasal cannulas (HFNC) for providing oxygen. “What an HFNC does is to push in great amount of oxygen inside the lungs. It works very well in an ICU scenario. But when you are in a situation like this where there is a dearth of oxygen, people tend to go for NIV so that you can cut on the usage of oxygen,” Dey told BusinessLine . With HFNC you need around 60 litres of oxygen per minute at higher flows, with NIV you can do that with 15 litres of oxygen, he said.
“If you remember, last year there were reports saying that Italy used so much of oxygen per hour. That was mainly because everyone was using HFNC. This was because it was the initial period and people were sceptical whether to go for HFNCs or NIVs. Slowly people started moving towards NIVs,” said Dey.
With ventilation, he said, it has always been a step-ladder approach. The patient comes in with a moderate disease, he is put on oxygenation, and is watched to see how he is responding. If the patient is responding well and is going back to mild disease, then it is fine. But if the saturation is dropping below 90 per cent, then we have to start thinking of NIV and other things. If the situation worsens further, the patient can be put on invasive ventilation, Dey observed.
He said as there is no intubation with NIV, the chances of a patient picking up hospital-acquired infection is on the lower side. With NIV, we need only a well-fitting mask, not intubation. Dey said currently even small hospitals in C-class cities in the country have adequate number of NIVs.
No price hike
According to him, major players inthe Indian NIV market are ResMed and Philips, even though there are many others. He said to the best of his knowledge, no firm has increased the price of NIVs since last year.
A basic NIV, with both hardware and software, costs ₹70,000 and upwards.
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