- Some doctors are trying to reduce their reliance on ventilators for coronavirus patients because of reports of abnormally high death rates for patients using the machines, The Associated Press reported on Wednesday.
- New York City officials have said at least 80% of coronavirus patients who were on ventilators in the city died, the AP reported. Unusually high death rates have also been recorded elsewhere in the US and the world.
- Ventilators are typically used only for the worst-affected patients, and there are no drugs approved to treat COVID-19, so this could help explain the higher death rate.
- But doctors have also said ventilators can damage the lungs — and while the machines may be an effective way to treat other respiratory illnesses, some are looking for alternative treatments.
- Because there is a global ventilator shortage, doctors and healthcare systems have called for more to be made or bought quickly to treat the worst-affected patients.
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Some doctors are trying to use ventilators less frequently as some areas have reported high death rates among coronavirus patients who were on them, The Associated Press reported on Wednesday.
Ventilators, machines used to bring oxygen into a person’s lungs, are typically used only for the patients worst affected by respiratory diseases.
Experts have said that some 40% to 50% of patients with severe respiratory issues die while on ventilators, the AP reported.
New York City officials have said at least 80% of coronavirus patients who were put on ventilators there ultimately died, the AP reported. New York state has the most confirmed coronavirus cases and deaths in the US.
There have also been reports of unusually high death rates among patients on ventilators elsewhere in the US and in China and the UK, the AP said.
Putting a person on a ventilator is an extreme step saved for the worst-affected patients, who typically already have the highest chance of dying from respiratory failure.
The higher death rates could be a result of this, as well as the fact that there are so far no drugs approved to fight the coronavirus.
Ventilators could be further harming coronavirus patients, some doctors say
Some doctors are also concerned that ventilators could be further harming certain coronavirus patients, as the treatment is hard on the lungs, the AP reported.
Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient’s lungs.
“The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs,” she said.
Dr. Negin Hajizadeh, a pulmonary critical-care doctor at New York’s Hofstra/Northwell School of Medicine, also told NPR that while ventilators worked well for people with diseases like pneumonia, they don’t necessarily also work for coronavirus patients.
She said that most coronavirus patients in her hospital system who were put on a ventilator had not recovered.
She added that the coronavirus does a lot more damage to the lungs than illnesses like the flu, as “there is fluid and other toxic chemical cytokines, we call them, raging throughout the lung tissue.”
“We know that mechanical ventilation is not benign,” Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.
“One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it.”
Doctors are trying to find other solutions and reduce their reliance on ventilators
The lack of treatment options for coronavirus patients has caused much of the world to turn to ventilators for the worst-affected patients.
But the high death rates reported among patients on ventilators have prompted some doctors to seek alternatives and reduce their reliance on ventilators, the AP reported.
Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.
“If we’re able to make them better without intubating them,” Habboushe said, “they are more likely to have a better outcome — we think.”
According to the AP, doctors are putting patients in different positions to try to get oxygen into different parts of their lungs, giving patients oxygen through nose tubes, and adding nitric oxide to oxygen treatments to try to increase blood flow.
Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was “all experimental,” the AP reported.
The global ventilator shortage
The global shortage of ventilators has become one of the big stories of the pandemic, as doctors around the world desperately try to treat patients.
Private companies in the UK have shifted to producing them because of a shortage in the health service, but they aren’t likely to make enough before the outbreak peaks in the country, The Guardian reported on Friday.
In Italy, doctors have had to decide which patients are more likely to survive and therefore who they will put on a ventilator; they have turned patients away because of the shortage.
In Spain, the police have asked people to donate snorkels so that their parts could be used to build makeshift ventilators.
In the US, New York Gov. Andrew Cuomo has decried a ventilator shortage in the state, while other states have said they’ve had to battle the federal government for new ones and enlisted private companies to fix broken ventilators received from the federal stockpile.
Multiple countries have also accused the US of seizing their orders of medical equipment, including ventilators. The Trump administration has denied this.
Some of the world’s biggest manufacturers have also announced plans to pivot to making ventilators, including the iPhone-maker Foxconn, Ford, GM, and Tesla. Meanwhile, employees of some other US companies, including GE, have protested, calling on their employers to make ventilators.
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