Reuters @reuters
'At one point I was so exhausted … I was saying, if I had no children or partner then it would be easier just to be left in peace,' COVID-patient Andre Bergmann on his fight to beat the virus without a ventilator 1/8
^More important, many doctors say, is that the additional machines will need highly trained and experienced operators.
"It's not just about running out of ventilators, it's running out of expertise," said David Hill, a pulmonology and critical care physician in Waterbury, Connecticut, who attends at Waterbury Hospital.
Long-term ventilation management is complex, but Hill said some U.S. hospitals were trying to bring non-critical care physicians up to speed fast with webinars or even tip sheets. "That is a recipe for bad outcomes."^
.@Reuters spoke to 30 medics worldwide who have experience of dealing with COVID-19 patients. They agreed ventilators are vital and have helped save lives. But many also highlighted the risks from using the most invasive types. 3/8
Many forms of ventilation use masks to help get oxygen into patients. Doctors are concerned about putting tubes into patients’ airways to pump air in, which can damage the lungs. 4/8
In Wuhan, China, where the novel coronavirus emerged, doctors said they initially intubated patients to help them breathe, but 'the disease had changed their lungs beyond our imagination.' 5/8
Putting COVID-19 sufferers on ventilators as if they were standard patients with breathing problems is 'like using a Ferrari to go to the shop next door, you press on the accelerator and you smash the window,' a ventilator expert told @Reuters. 6/8
COVID-19 is teaching doctors how to handle coronavirus #happyhypoxics - people who can talk and laugh with no signs of mental cloudiness even though their oxygen might be critically low. 7/8
Read the full @SpecialReports: As virus advances, doctors rethink rush to ventilate t.co/22y5HmcboI by @tomescritt @silviaaloisi @gabriellaborter @kkelland @journotopia & Deena Beasley 8/8
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Special Report: As virus advances, doctors rethink rush to ventilate
In China, 86% of 22 COVID-19 patients didn't survive invasive ventilation at an intensive care unit in Wuhan, the city where the pandemic began, according to a study published in The Lancet in February. Normally, the paper said, patients with severe breathing problems have a 50% chance of survival. A recent British study found two-thirds of COVID-19 patients put on mechanical ventilators ended up dying anyway, and a New York study found 88% of 320 mechanically ventilated COVID-19 patients had died.
And
In a paper published by the American Thoracic Society on March 30, Gattinoni and other Italian doctors wrote that COVID-19 does not lead to "typical" respiratory problems. Patients' lungs were working better than they would expect for ARDS, they wrote - they were more elastic. So, he said, mechanical ventilation should be given "with a lower pressure than the one we are used to."
Dh has made the point that in forcing technology change whilst we might see a lot of deaths now, development of non invasive systems to ventilate patients could help to save lives (for all causes) in the future.