Are ventilators being overused on COVID-19 patients?

10 Apr, 2020
Not all patients with severe COVID-19 infection may benefit from a ventilator.

Some physicians caring for COVID-19 patients question whether the threshold for placing someone on a ventilator should be raised, given that the breathing machines are in critically short supply nationwide, Stat News reported.

"I think we may indeed be able to support a subset of these patients" with less invasive breathing support, Dr. Sohan Japa, an internal medicine physician at Brigham and Women's Hospital in Boston told Stat News. Ventilators push oxygen into the lungs via a tube placed in the mouth, nose or a hole in the front of the neck; but less invasive devices like the breathing masks for sleep apnea could be used to treat some COVID-19 patients, at least at first.

Indeed, for COVID-19 patients who need breathing assistance, many hospitals are starting them off on sleep apnea devices or nasal cannulas, which deliver air into the nose through a pronged tube, Dr. Greg Martin, a critical care physician at Emory University School of Medicine in Atlanta , told Stat News. 

These noninvasive devices offer some advantages compared with ventilators. For example, the process of intubating patients — placing a tube into their airway — to  hook them up to a ventilator requires doctors to sedate patients for long periods of time, so the machine can take over the work of breathing, Stat News reported. 

In contrast, noninvasive breathing support devices don't "require sedation, and the patient [remains conscious and] can participate in his care," Martin said. If that person's respiratory issues degrade further, then doctors can put them on a mechanical ventilator," he added.

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