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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsNew analysis recommends less reliance on ventilators to treat coronavirus patients
STAT
By SHARON BEGLEY APRIL 21, 2020
By using ventilators more sparingly on Covid-19 patients, physicians could reduce the more-than-50% death rate for those put on the machines, according to an analysis published Tuesday in the American Journal of Tropical Medicine and Hygiene.... The new analysis, from an international team of physician-researchers, supports what had until now been mainly two hunches: that some of the Covid-19 patients put on ventilators didnt need to be, and that unusual features of the disease can make mechanical ventilation harmful to the lungs.
If a Covid-19 patient is clearly struggling to breathe, then invasive ventilation makes sense, wrote Marcus Schultz of Amsterdam University Medical Centers and his colleagues. But using low levels of blood oxygen (hypoxemia) as a sign that a patient needs mechanical ventilation can lead physicians astray, they argue, because low blood oxygen in a Covid-19 patient is not like low blood oxygen in other patients with, for instance, other forms of pneumonia or sepsis.
The latter typically gasp for breath and can barely speak, but many Covid-19 patients with oxygen levels in the 80s (the high 90s are normal) and even lower are able to speak full sentences without getting winded and in general show no other signs of respiratory distress, as their hypoxemia would predict..In our personal experience, hypoxemia
is often remarkably well tolerated by Covid-19 patients, the researchers wrote, in particular by those under 60. The trigger for intubation should, within certain limits, probably not be based on hypoxemia but more on respiratory distress and fatigue.
...Without effective drugs, surviving severe Covid-19 depends on supportive care, including breathing support where necessary. But recommendations for that care are largely based on guidelines for other viral pneumonias and sepsis. That explains the second reason ventilators arent helping more patients: Covid-19 affects the lungs differently than other causes of severe pneumonia or acute respiratory distress syndrome, the researchers point out, confirming what physicians around the world are starting to realize.
More here
https://www.statnews.com/2020/04/21/coronavirus-analysis-recommends-less-reliance-on-ventilators/
marybourg
(12,634 posts)Is that true?
bronxiteforever
(9,287 posts)reading is typically between 95 and 100 percent.
https://www.healthline.com/health/normal-blood-oxygen-level#oxygen-levels