Are ventilators deathtraps?

[AnonymousWoman]

www.dailymail.co.uk/news/article-8230775/Is-proof-live-saving-ventilators-actually-deathtraps.html

The article says it all really. It may be okay to ventilate for other illnesses such as pnuemonia but maybe not for Covid- 19.

[Lweji]

Thanks for your post.

I wouldn't know.
There was mention of people on much lower O2 levels.

I know that DS got to levels around 80s but was only put on oxygen, when he had bronchiolitis.

On the link there was another link to a letter by Italian doctors. They recommended putting ventilators on low pressure, IIRC.

[FOJN]

Lweji
The articles you have linked to are American. I haven't worked in ICU for a few years but when I did ( in the UK) there is no way we would have intubated a patient with O2 sats of 93% so I wonder how different the ventilation strategies are in different countries. The information about high pressure damaging the lungs has been known about for a very long time. I was trained in how to minimise the risk of this 25 years ago. Modern ventilators are very sophisticated but they do require the clinicians to understand how to use them to get the best out of them.

I agree the DM headline is daft.

[Lweji]

The point some doctors seem to be making is that it's possible that some patients are being put on ventilators too early.

Deathtraps is just DM stupidity.

[cloud1183]

They aren’t deathtraps at all. The fact is that anybody that needs a ventilator has a very poor prognosis anyway and it’s a last resort. That’s why there’s a criteria for who is suitable to be ventilated or not. It takes months if not years to return to normality if you have been ventilated

[Lweji]

From Time magazine

time.com/5820556/ventilators-covid-19/

[Lweji]

www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

The medicinenet article linked above as well.

I'm sure doctors are evaluating all the data and adapting their practices accordingly.

If this is true, though, it is good news for settings with fewer ventilators, just as long as there's enough oxygen.

[Lweji]

I’d have thought that doctors and medical scientists were better placed to investigate the thesis than mumsnetters

My thoughts, exactly. Even the specialist doctors on MN MN won't care what MNetters think about this.

In any case, I'd read something about this a while ago.
It seems that the type of pneumonia caused by coronavirus is different from most pneumonias. Doctors were reporting people with very low blood oxygen levels but who didn't seem to be that bad. It seems that the air sacks get covered in mucus (?) and simply forcing air into the lungs not only doesn't seem to help, but could damage the lungs. There was the thesis that patients did better with increased oxygen instead, just via the nose.
The other theory, or in addition, was that weakened patients didn't cope well with the sedation necessary.
Sorry, this is from memory. I'll try to find sources.

[ColleysMill]

Aside from all the previous points made about ventilation, this isnt the first time ive read the theory that ventilation may not be the best treatment amd hyperbaric chambers may be better so even though its Daily Mail i wouldn't be too quick to dismiss it out of hand ..

[pokemongrief]

People going into ventilators are very ill to start with and often have serious underlying conditions. Mechanical ventilation puts enormous stress on the body so they are at a disadvantage anyway.

[mamabears3]

in a nutshell
if you cant breathe adequately to oxygenate your brain, organs and blood (entire body) you will eventually die
ventilators will do this for you (hopefully) or even ecmo (its complex)
death or artificial ventilation
its a choice

[bakingdiva]

There is an article in The Times today by one of their journalists who was ventilated with Covid-19, talking about his recovery. He is back home so they obviously do work for some. However, my understanding is that once you're at the stage of needing to be ventilated your chance of survival is pretty poor anyway.

[iVampire]

I thought it was a new disease and there is evolving and ongoing understanding about how best to treat

I think you’re right. But getting enough oxygen into a person whilst you work out other aspects of treatment is pretty dammed important. Because if you don’t, they die.

So for the most serious cases, the choice is 50/50 (with ventilation) or certain death (without)

Ventilation when there are still other, less invasive, options is not the British treatment pathway

[iVampire]

That article strikes me as complete bollocks which ignore that things like proning and oxygen support other than by ventilator are standard practice in British ICUs, and that only those who do not benefit from those interventions are then ventilated (death rate for those needing ventilation about 50/50, but one third of those admitted to ICU recover without ventilation)

[enjoyingSun]

This link was on the daily numbers thread -
www.medicinenet.com/script/main/art.asp?articlekey=230110#

Same story with less eye catching headline


source: MedicineNet Health News

Some doctors are questioning the way ventilators are being used for people with serious cases of COVID-19. Why? More data shows a high death rate for patients treated under current ventilator practices.

At the same time, these doctors are saying their patients behave more like they have high altitude sickness than a viral infection.


I thought it was a new disease and there is evolving and ongoing understanding about how best to treat.

[xyz2020]

This was featured on Newsnight last night. I understood doctors were looking to change the protocol, or at least, recommending it. It's on catch up

[Portabella24]

I have been ventilated after a traumatic birth. I was put into an artificial coma to recover. When conscious, I found being ventilated very uncomfortable and frustrating (obvs you can't speak) but after being extubated I quickly developed pneumonia. This was 15 years ago so things might have changed but I was told that this is very common. I was 30 so recovered quickly (with physio to help me cough properly) but I can imagine it is quite a traumatic experience if you are frail or weak. I don't know why people can't be given oxygen earlier although my local hospital has said it is running low so perhaps that's the answer.

[Flaxmeadow]

Interesting article thanks

[FinnsLeftSpoon]

PuzzledObserver Quite a few Mumsnetters are doctors and medical scientists.

[FOJN]

Fuck me, so much bollocks in one article. The suggestion is coming from a "junior casualty doctor". I'd rather listen to an intensivist, respiratory specialist or anaethetist. They don't even explain proning correctly, I'd like to see anyone try to get a self ventilating patient who is gasping for breath to lie on their stomach? This is shockingly irresponsible journalism.

[JackJackIncredible]

ARDS has a relatively high mortality rate anyway, 30-50%.

[1forAll74]

From what I have read of late, to be ventilated is quite an unpleasant experience,although a person has to be sedated throughout. They must be deemed as beneficial to some people,or they would not use them.

For some very sick people the apparatus just won't provide a miracle recovery sadly.

As an add on, I am an oldie, and remember the 1950 era, when an Iron Lung was used widely for polio,and they were very scary looking machines,doing what modern ventilators do now. I knew a couple of my school friends who had to go in an Iron Lung, I didn't see them, but photo's of the contraption were quite horrible.

[Emerald89]

Physically tire **

[Emerald89]

You don’t just ventilate for the bilateral viral pneumonia. They develop ARDS and can physically from air hunger.

The article is written really oddly, talks about how ventilators help your muscles but people with COVID have normal muscles. Makes no effing sense.

[milveycrohn]

All I know is that I remember an Italian doctor saying that in his hospital, ALL those on ventilators did not survive.
Obviously we know that some on ventilators DO survive (presumably in other hospitals, and in the UK) as we have heard their stories.
It seems to depend on how long they are on a ventilator for.
I actually thought the article very thought provoking and interesting. So little is known about the virus, I just hope the medical profession around the world are collaborating with each other.
(I am not a medical person)

[mumwon]

amazing that its only one doctors opinion - maybe he prefers to let people die because ventilators are the last ditch of keeping really sick people alive without them they would die obviously the investment into PAP to prevent their condition deteriorating to this later stage