Over 80% of COVID patients places on Ventilators in New York City have died.

According to Margaretta Colangelo

When the COVID-19 outbreak first started there was a lot of discussion about ventilators. In the beginning, people discussed the need for more ventilators in hospitals or the attempts to repair malfunctioning ventilators. In March is was estimated that although 960,000 patients in the US might need a ventilator, only about 200,000 machines were available. People are still talking about ventilators, but this month, the discussion has changed. According to state and city officialsOver 80% of COVID patients placed on ventilators in New York City have died. Experts report that generally 40% of patients with severe respiratory distress die while on ventilators. Almost twice as many COVID patients are dying while intubated on a ventilator.

Ventilators are used in hospital intensive care units to move air into and out of the lungs when a patient's breathing is compromised. COVID attacks the respiratory system and some patients who are infected struggle to breathe. A few weeks ago it was routine to place COVID patients on ventilators to keep them breathing and according to Governor Cuomo, it’s been common for COVID patients in New York to be on ventilators for 10-15 days. In comparison, patients with bacterial pneumonia are typically placed on ventilators for a few two days and the majority recover. Image: Fluidda

Doctors have been working under the assumption that some COVID patients develop acute respiratory distress syndrome (ARDS) and that the best approach for treating these patients is with ventilators. Some ICU doctors are questioning whether standard respiratory therapy protocol for ARDS is the best approach for treating patients with COVID pneumonia and if respiratory therapy is doing more harm than good. Doctors are calling for a review and possibly a revision to guidelines for treating COVID patients in the ICU. Normal oxygen saturation rate is 95% -100%. When oxygen saturation rate drops below 93% it is usually seen as sign of potential hypoxia. Prior to the COVID pandemic, when the oxygen level dropped below 93%, doctors typically used noninvasive devices such as face masks with tubes to supply oxygen.

In March, doctors in Germany reported that COVID does not lead to a typical ARDS, that intubation was leading to additional lung damage, and that overall the treatment was not having much success. In a letter published in the American Journal of Respiratory and Critical Care Medicine and. A letter soon to be published in Intensive Care Medicine, Luciano Gattinoni, MD, and his colleagues at the Medical University of Göttingen in Germany, question whether protocol-driven ventilator use for patients with COVID could be doing more harm than good. They suggested that that instead of high positive end-expiratory pressure, perhaps doctors should use the lowest possible pressure and gentle ventilation to minimize damage to the lungs. Dr. Gattinoni describes two variations of COVID, Phenotype L and Phenotype H, each of which require different treatments.