Physicians rethinking use of ventilators for some COVID-19 patients

Some COVID-19 patients come to the hospital with low blood oxygen levels — levels that should have them gasping for air — but instead, these patients are awake and talking, resulting in some physicians rethinking the use of ventilators for them, according to The Wall Street Journal.

It is unclear why certain COVID-19 patients are unaffected by low blood oxygen levels and able to tolerate them, but some physicians are now holding off invasive mechanical ventilation for these patients.

Initially during the pandemic, physicians would rush to intubate these patients sooner, afraid of their sudden and swift deterioration. But recently, physicians at Stony Brook (N.Y.) Hospital and Ochsner Medical Center-West Bank Campus in Gretna, La., have put these patients on ventilators less often and are instead using other machines, such as CPAP machines, BiPAP machines or high-flow nasal cannulas.

Scott Weingart, MD, chief of emergency critical care in the department of emergency medicine at Stony Brook Hospital told the Journal about a 42-year-old COVID-19 patient with dangerously low blood oxygen levels, who was able to sit up and talk. Dr. Weingart and his team used a high-flow nasal cannula to increase the patient's blood oxygen levels and placed the patient on his stomach, called "prone positioning," which can boost oxygen levels. The patient was discharged without being placed on a ventilator.

The hospitals eschewing the use of ventilators in favor of CPAP and BiPAP machines are also careful to use filters on the masks and keep patients in specially ventilated rooms since these devices could release the virus into the air, they told the Journal.

Ventilators have played a key role in COVID-19 patient care during the pandemic, and as a result, demand for the machines soared. But their use comes with several risks. Studies have shown that many COVID-19 patients placed on ventilators die. A recent study published in the Journal of the American Medical Association showed that of 320 New York state patients who received invasive mechanical ventilation, 88.1 percent died.

More articles on patient safety & outcomes:
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Pregnant COVID-19 patients no worse off than nonpregnant counterparts, study finds



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