Most COVID-19 Patients put on ventilators will not survive

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Most COVID-19 Patients put on ventilators will not survive

While governors, mayors and hospital officials conduct much-publicized life-and-death
struggles to acquire ventilators
, for most COVID-19 patients the oxygen-providing apparatus will merely serve as a bridge from life to death. New York Gov. Andrew Cuomo recently estimated that only 20% of coronavirus patients placed on ventilators “will ever come off.” Dennis Carroll, who led the U.S. Agency for International Development’s infectious disease unit for more than a decade, told USA TODAY perhaps one-third of COVID-19 patients on ventilators survive. But for many, ventilators
represent their last chance
. “If you were one of the one-third, I suspect you’d be very appreciative that that capability was available,” Carroll said. Ventilators won’t fix the ailments that put patients on them, but they can provide support until other treatments work or the patient’s body overcomes the disease. And physicians are determined to use the tool in the last-ditch effort to keep patients alive. At Lenox Hill Hospital on Manhattan’s Upper East Side, “hope huddles” allow emergency room staffers to take a moment amid the suffering to discuss small victories – such as successful “extubations” when patients are weaned from the machines. “Our goal is to save the most number of lives possible, while also being realistic when evaluating a person’s chances of survival,” said Robert Glatter, an emergency physician at Lenox Hill. ‘Buying time’ for coronavirus patients A ventilator uses “positive pressure” to blow air into the lungs through a tube inserted in the patient’s nose or mouth and moved down into the airway. Longer-term ventilation can involve the tube being introduced through the windpipe. Patients generally exhale on their own, but sometimes the ventilator helps with that as well. “Ventilators aren’t really making any therapeutic contributions,” said Ogbonnaya Omenka, an assistant professor and public health specialist at Butler University’s College of Pharmacy and Health Sciences. “What they do in essence, is provide life support – and buy time for the patient.” Some patients may be on a ventilator for only a few hours or days, but experts say COVID-19 patients often remain on the ventilators for 10 days or more. Longer duration of intubation is often related to worsening acute respiratory distress syndrome, ARDS. And patients who have issues with kidneys or other organs in addition to lungs stay intubated for longer periods of time. Melissa Nolan, an infectious disease expert and professor at the University of South Carolina, said people on ventilators tend to be the most critically ill patients and often are receiving renal or cardiovascular mechanical support that can further complicate their chance of recovery. There are risks associated with ventilators. The artificial breathing tube sometimes can allow germs to enter the lungs, causing infection. But for these patients there are no alternatives. “Ventilation and intubation are currently our best tools for treating the pulmonary manifestations of COVID-19 – and often clinicians’ only choice” given the lack of effective drug therapies, Nolan said.

Most COVID-19 Patients put on ventilators will not survive

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