‘Substantial increase’ in mechanical ventilators reported by acute care hospitals in 2020

A new study highlighted an increase in adult and pediatric mechanical ventilators reported by acute care hospitals in 2020 during the COVID-19 pandemic compared with 2019.

“Despite the unprecedented demand for mechanical ventilators in the U.S. during the COVID-19 pandemic, the last survey of U.S. hospitals occurred in 2010 and estimated approximately 62,000 full-featured ventilators. ... Therefore, we performed an updated assessment of current ventilators in use at U.S. hospitals to aid with current and future pandemic preparedness and to determine whether any change was correlated with COVID-19 burden.” Thomas C. Tsai, MD, MPH, of the department of surgery at Brigham and Women’s Hospital and the department of health policy and management at Harvard T.H. Chan School of Public Health, and colleagues wrote in JAMA Network Open.

The cross-sectional study used survey data from 2,712 U.S. adult acute care hospitals and 1,103 hospitals providing pediatric care that responded to the 2020 American Hospital Association Annual Survey, which aimed to estimate the increase in mechanical ventilators. Questions regarding ventilators were designed in response to the COVID-19 pandemic. Researchers merged data from the American Hospital Association with U.S. Census data and COVID-19 burden data from HHS for 2020 to assess whether the increase in adult and pediatric mechanical ventilators in the U.S. varied across hospital structural features, region and safety-net status.

Researchers reported the multivariate adjusted relative increase in adult mechanical ventilators in 2020 was 31.5% (P < .001). The increase in mechanical ventilators during the pandemic did not vary across hospital characteristics including size, region, profit status, teaching status, critical access status, urban or rural location and safety net.

The multivariate adjusted relative increase in pediatric and neonatal mechanical ventilators in 2020 was 15.6% (P = .03).

Regionally, acute care hospitals in South Carolina, Alaska, Nevada, Idaho and Mississippi had the lowest number of adult mechanical ventilators per 100,000 population compared with New York, Louisiana, Arkansas, North Dakota and Washington, D.C., which had the highest per capita mechanical ventilator supply. State-level increases in mechanical ventilators did not correlate with state-level ICU burden (P = .37), according to the researchers.

“This cross-sectional study found a substantial increase in adult and pediatric mechanical ventilators reported by acute care hospitals in 2020 compared with 2019. ... For both the current COVID-19 pandemic as well as future pandemic preparedness, these findings may help guide policymakers in deploying ventilators to states with the most urgent need of ventilators,” the researchers wrote.