While public health officials around the world seek to get more equipment for artificial lung ventilation (ALV) for treatment of patients withCOVID-19, some doctors try to avoid their use, reports AP News.
Reason: several hospitals have reported unusually high mortality of patients with coronavirus, which is hooked up to a ventilator. Some doctors fear that the machines can even cause harm in certain patients.
Doctors are still studying the best way to fight the virus, which appeared only a few months ago. They rely on unconfirmed reports in real time on the background of a large number of patients and shortage of materials.
Mechanical ventilators deliver oxygen to the patients lungs which can not cope with this task due to severe inflammatory process. To use the machine, you must enter the patient’s anesthetic and insert a tube down your throat. Deaths among such patients are common, regardless of the reason why they need help breathing.
According to statistics, from 40% to 50% of patients with severe respiratory disorders die while on a ventilator. But the mortality of patients with coronavirus, is connected to a ventilator in new York, was more than 80%, representatives of the state and the city.
According to Dr. albert Rizzo, chief of the medical worker the American Association of the lung, and in other places in the U.S. the mortality rate is connected to the mechanical ventilation of patients with Covid-19 was above the average for people with respiratory disorders.
Similar messages also come from China and the UK. In one of the British reports the percentage mortality of these patients was 66%. A very small study in Wuhan, a Chinese city where the virus first appeared, showed that 86% of patients, which was connected to a ventilator and died.
The reason is not clear. This may be due to the fact, in what form were patients before infection. According to some experts, this may be related to how much they got sick to the time when they are hooked up to a ventilator.
But some medical professionals wonder if a hundred ventilators actually aggravate the situation, some patients, perhaps due to activation or deterioration of the quality of the immune response.
This assumption. But experts say that prolonged use of the ventilator could harm the patient because the oxygen gets into the alveoli — tiny air sacs in the lungs under too high pressure.
“We know that mechanical ventilation is not ideal, said Dr. eddy Fan, an expert in respiratory treatment in the General hospital in Toronto. — One of the most important insights over the past few decades is that medical ventilation can aggravate lung injury, so we have to be careful when using it”.
According to the Fan, the danger can be reduced by limiting the pressure and volume of air supplied to the lungs by a machine.
But some doctors say that they try as much as possible not to use ventilators and instead resorted to other methods.
“Just a few weeks ago in new York patients with the coronavirus, which appeared complications, were regularly placed under the ventilator to give them a chance to breathe,” said Dr. Joseph Hubbuch, an emergency physician working in hospitals in Manhattan.
But now doctors are increasingly trying to first take other measures. One of them is that patients put in different positions, including on the stomach to a natural way to provide the best lung function. Another way to give patients more oxygen through nasal tubes or other devices. Some doctors are experimenting with the addition of nitric oxide to the mix to help improve the flow of blood and oxygen has to be provided in the least damaged part of the lungs.
“We think that if we can do without intubation is likely, patients will have the best result,” said Hubbuch.
He noted that these solutions are not associated with a shortage of medical ventilators. But this is also a problem, added Habbos.
According to Dr. William Shaffner, the infectious disease expert at Vanderbilt University, there are widespread reports that patients with coronavirus usually are on a ventilator much longer than other patients.
Experts say that patients with bacterial pneumonia, for example, may be on ventilator for more than a day or two. But patients with coronavirus are often on the ventilator from 7 to 15 days, after which many of them die.
Another reason for concern is the anticipated shortage of medical ventilators. Experts are concerned that with rising cases of infection, doctors will be forced to make awful decisions about who should live and who should die, because they will not have enough machines for every patient who needs them.
On Wednesday, the Commissioner of health of the state of new York, Dr. Howard Zucker said that officials are studying other possible treatments, but added that “it’s all experimental”.
The new virus belongs to the family of coronaviruses that cause the common cold and more serious diseases. Health officials say that it applies mainly droplets when an infected person coughs or sneezes. There is no proven treatment or vaccine against it.
Experts believe that in most cases, infected people had mild symptoms that can include fever and cough.
But about 20% — many of them elderly or people weakened by chronic illness may suffer a lot stronger. They can develop breathing problems and chest pain. Their lungs can become inflamed, causing a dangerous condition called acute respiratory distress syndrome. It is estimated that between 3% to 4% of patients can require the ventilator.
“The ventilator is not therapy. This auxiliary measure, while we wait that the patient will recover,” said Dr. Roger Alvarez, a specialist in easy to the health system of the University of Miami in Florida.
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