Doctors rethinking coronavirus: Are we using ventilators the wrong way?
Caitlin Dickson • April 8, 2020

https://www.yahoo.com/news/rethinking-coronavirus-some-doctors-question-how-we-use-ventilators-123733204.html

Across the country, hospital administrators, doctors and public officials are pleading for ventilators, as the spread of coronavirus is making growing numbers of patients dependent on the machines that pump oxygen into their lungs to keep them alive. The subject comes up at almost every White House briefing on coronavirus, and the administration has even proposed an emergency effort to retool automobile factories to make more of the devices.

In New York, the epicenter of the coronavirus outbreak in the U.S., Gov. Andrew Cuomo has largely focused his energy on efforts to bolster the state’s dwindling stockpile of ventilators, while officials in a number of other states have begun developing or updating guidelines for how to ration ventilators in the event of a shortage.

But while hospitals and health care workers grapple with the grim reality that they may soon be forced to deny potentially life-saving treatments to certain patients due to a lack of supplies, some doctors are raising questions about how ventilators are currently being used on coronavirus patients — and whether they may actually be doing more harm than good. Early reporting on coronavirus deaths from China, Italy and the U.S. show that more than half — and as many as two-thirds — of COVID-19 patients who are placed on ventilators don’t survive.

“What we’re doing now is not working, and I think making the same mistake over and over is a sign of stupidity,” Dr. Paul Marik told Yahoo News. “If it’s not working, we’ve got to look for something else.”

Marik is promoting a treatment of his own devising, a combination of corticosteroids and high-dose ascorbic acid, or vitamin C, as a first-line therapy for patients hospitalized with COVID-19. Marik is a respected clinician, chief of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School. The protocol is controversial and untested, but the theory behind it illuminates a growing shift in thinking about the disease that may have important implications for how it is treated.

Marik’s theory is based on an idea that is becoming widespread among researchers: that the cause of death for a significant number of COVID-19 patients, especially younger ones, is severe inflammation of the lungs resulting from an overly vigorous immune-system response. By administering anti-inflammatory drugs early and regularly after a patient is admitted to the emergency room, Marik believes he can prevent this complication, known as a “cytokine storm.”

In those cases, “it’s not the virus that’s killing the host, it’s the host’s response to the virus,” said Marik. Coronavirus is highly contagious and can cause fatal disease in some patients, but immune reactions to the infection varies dramatically from person to person.


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More FTA:

In addition to early anti-inflammatory treatment, the protocol followed by Marik and his colleagues includes alternatives to using a ventilator, a machine that delivers oxygen under pressure directly into the trachea by means of a tube inserted through the mouth. This requires deep sedation and prevents the patient from talking. He favors a technique called high-flow nasal cannula therapy, which delivers humidified and heated oxygen through nostril tubes, a less invasive procedure than intubation, and suggests positioning the patient on the stomach to improve oxygenation.

The goal is to delay, or avoid entirely, the need for the patient to go on a ventilator.

“Plenty of patients will need to go on a ventilator, you can’t help it, but you want to do whatever you can to prevent [that],” said Marik, adding that “fewer patients that go on ventilators, frees up [more] for those who really need them.”

For those who need to be intubated, however, Marik and his colleagues are also recommending a different, gentler approach than the high-pressure ventilator settings typically used for patients with acute respiratory distress syndrome (ARDS), which Marik and others believe may actually be causing damage to the lungs of patients with COVID-19.

“It’s becoming a vicious cycle,” said Marik. “The ventilator is causing lung injury, which causes them to stay on the ventilator longer, and basically is depleting the supply of ventilators for people who need them.”

Marik and his colleagues are not the only ones who believe a new approach may be needed to treat this new disease.

Quote: Greta wrote in post #4

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I think this article is basically saying the same thing.... stop with the vents. Covid-19 had us all fooled, but now we might have finally found its secret.

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Quote: austingirl wrote in post #7

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Has the ventilator-whiner heard about this? Does he have his 30,000 ventilators yet? Have all US industries converted to the production of these lung-damaging machines. This is what listening to entrenched bureaucrats with an agenda gets you.

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Quote: Greta wrote in post #4

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I think this article is basically saying the same thing.... stop with the vents. Covid-19 had us all fooled, but now we might have finally found its secret.

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