May be harmful: some doctors refuse ventilators for treatment of COVID-19
So far, health care providers around the world are seeking to get more mechanical ventilation devices (mechanical ventilation) for the treatment of patients with COVID-19, some doctors try to avoid their use whenever possible, reports AR News.
Reason: In several hospitals, unusually high mortality rates for patients with coronavirus who are connected to mechanical ventilation are reported. Some doctors fear that machines may even harm certain patients.
Doctors are still studying the best way to fight the virus, which appeared just a few months ago. They rely on unconfirmed real-time data amid a large number of patients and a lack of materials.
Mechanical fans deliver oxygen to the body of patients whose lungs cannot cope with this task due to a strong inflammatory process. To use the machine, it is necessary to anesthetize the patient and insert the tube into the throat. Fatalities among these patients are common, regardless of the reason they need help breathing.
According to statistics, from 40% to 50% of patients with severe respiratory disorders die while using a ventilator. While mortality of coronavirus patients connected to mechanical ventilation in New York amounted to more than 80%, state and city officials say.
According to Dr. Albert Rizzo, chief medical officer of the American Lung Association, and elsewhere in the US, mortality rates for patients with mechanical ventilation with COVID-19 were higher than the average for people with respiratory disorders.
Similar messages also come from China and the UK. In a British report, the mortality rate for such patients was 66%. A very small study in Wuhan, the Chinese city where the virus first appeared, showed that 86% of patients who were connected to mechanical ventilation died.
The reason is not clear. This may be due to the form in which the patients were before infection. According to some experts, this may be due to how much they fell ill by the time they were connected to the ventilator.
But some medical workers are wondering: what if ventilators actually aggravate the situation in some patients, possibly due to activation or deterioration in the quality of the response of the immune system.
This is an assumption. But experts say prolonged use of a ventilator can harm the patient as oxygen enters the alveoli - tiny air sacs in the lungs - at too high a pressure.
"We know that mechanical ventilation is not ideal," said Dr. Eddie Phan, a respiratory care expert at Toronto General Hospital. “One of the most important findings over the past few decades is that medical ventilation can worsen lung injury, so we need to be careful when using it.”
According to Fan, the danger can be reduced by limiting the pressure and volume of air supplied to the lungs by the machine.
But some doctors say they try not to use ventilators for as long as possible and instead resort to other methods.
“Just a few weeks ago in New York, coronavirus patients who developed complications were regularly placed under ventilators to allow them to breathe,” said Dr. Joseph Hubbush, an emergency doctor who works at Manhattan hospitals.
But now doctors are increasingly trying to take other measures first. One of them is that patients are placed in different positions, including on the stomach, in order to naturally ensure better lung function. Another way is to give patients more oxygen through nasal tubes or other devices. Some doctors are experimenting with adding nitric oxide to the mixture to help improve blood flow and oxygen to the least damaged parts of the lungs.
“We think that if we can do without intubation, the patients are more likely to have a better outcome,” said Hubbush.
He noted that these decisions are not associated with a shortage of ventilators. But this is also a problem, Hubbusch added.
According to Dr. William Schaffner, an expert on infectious diseases at Vanderbilt University, there are widespread reports that patients with coronavirus usually stay on mechanical ventilation for much longer than other patients.
Experts say that patients with bacterial pneumonia can be on the ventilator for no more than a day or two. But patients with coronavirus are often on the ventilator for 7 to 15 days, after which many of them die.
Another cause for concern is the expected shortage of ventilators. Experts are concerned that as infections rise, doctors will be forced to make dire decisions about who should live and who should die because they won't have enough cars for every patient who needs them.
New York State Health Commissioner Dr. Howard Zucker said Wednesday that officials are exploring other possible treatment options, and “it's all experimental.”
The new virus belongs to the family of coronaviruses that can cause both the common cold and more serious diseases. Health officials say it spreads predominantly by airborne droplets when an infected person coughs or sneezes. There is no proven medicine or vaccine against it.
Experts believe that in most cases, infected people have mild symptoms, which may include fever and cough.
But about 20% (many of them elderly or people weakened by chronic diseases) can suffer much more. They may have breathing problems and chest pain. Their lungs can become inflamed, causing a dangerous condition called acute respiratory distress syndrome. It is estimated that 3% to 4% of patients may require mechanical ventilation.
“Mechanical ventilation is not a therapy. This is a supportive measure while we wait for the patient's body to heal, ”said Dr. Roger Alvarez, a lung specialist at the University of Miami Florida health system.
As reported by ForumDaily:
- A new virus was discovered in the Chinese city of Wuhan in December 2019. In 2020, it covered all continents except Antarctica. On March 11, US President Donald Trump imposed a ban on entering the United States from EU countries. The ban came into force on Friday, March 13, and will last at least 30 days. In particular, it will concern people who have visited the Schengen area over the past 14 days.
- March 13 Trump due to coronavirus introduced a nationwide emergency regime in the US.
- On March 11, WHO recognized the situation with the coronavirus pandemic, which covered more than 110 countries. Symptoms of Coronavirus COVID-19 Disease Available here.
- Virologist's tips on how to protect yourself from infection - link.
- Taking advantage of the panic in the society because of the epidemic, fraudsters came up with several schemes to deceive victims of personal data and money. The most common ones can be found here.
- Having succumbed to panic due to a state of emergency, Americans are massively buying toilet paperbut they cannot explain why they need it during the epidemic.
- Trump has signed into law on paid leave due to coronavirus. Who can count on paid leave, read here.
- Read all news about coronavirus in our special project.
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