MURRAY – In severe cases of COVID-19, it may be inevitable to be connected to a ventilator, but local health officials say that once a patient has reached this point, the survival rate is unfortunately relatively low.
According to a March this year article on Healthline.com, a mechanical ventilator is a device that pumps air into the lungs of a person who is severely unable to breathe.
“COVID-19 can cause respiratory symptoms such as coughing, difficulty breathing and shortness of breath,” the website said. “In severe cases, it can lead to a life-threatening condition known as acute respiratory distress syndrome.”
Healthline reported that ventilators can save lives for people with severe respiratory symptoms and that approximately 2.5% of people with COVID-19 require a mechanical ventilator. These ventilators are connected to tubing down the neck and are often used in intensive care units where hospitals treat COVID-19 patients with severe symptoms. The devices support the patient’s lungs by maintaining optimal air pressure and supplying oxygen to the lungs by taking over the patient’s breathing process either partially or entirely.
“During the first wave of COVID-19, around 75% of people admitted to intensive care units were connected to a mechanical ventilator,” reported Healthline. “Now the rate is only about half that as medical professionals have more knowledge of how best to treat the disease.”
However, the article also states that putting on a ventilator is considered a high risk procedure due to possible complications and puts health workers at risk by exposing them to the virus. Healthline reported that one of the most common complications is pneumonia because bacteria and viruses can easily get into the lungs through the breathing tube. The process of turning off a ventilator can also take days or months, gradually weaning the patient off the ventilator once they can breathe on their own.
Jerry Penner, CEO of Murray-Calloway County Hospital, said the hospital had six or seven patients on ventilators about 2 1/2 weeks ago, which was the most he had seen since his time at MCCH. He said they were all COVID related.
“Most of the time, venting a patient is not a good sign,” Penner said. “We celebrated not long ago weaning a person off a fume cupboard just because it doesn’t happen that often. When you get to that point, your lungs are damaged to really, really damaged. They need all the help they can get in getting as much oxygen into the lungs as possible. The death rates are high when they get to the chimneys. “
Penner said he wasn’t sure what the national death rate is for COVID patients plugged into ventilators, but he’s heard numbers as high as 90%.
“I don’t know how that works in the environment, but 90% is not good, (which means that there is a 10% survival rate after being on a drain,” said Penner. “We use anything other than (previously a ventilator) at this point. We have high flow oxygen to keep people out (ventilators) and we are doing everything we can to help them. Again, the lungs are extremely damaged at this point and we have to do all we can to fix it To help patient and hopefully get a survival out of him.
“We’ve had people who have been relegated and I hope our numbers are better than the national average, but I know there have been difficult times in other places.”
Penner said death rates might differ from hospital to hospital because some could send their patients with severe symptoms to ventilators earlier while others could suspend them as a last-ditch effort.
“If it’s one last effort on you, that percentage will be higher, so it’ll skew your data a little,” Penner said. “We don’t jump right in on it. We try to keep them out of the vent for as long as possible while another hospital will (maybe not wait). I know that because I’ve discussed this with other hospitals that are more aggressive at the beginning. They say, ‘OK, let’s just pull them to a hood now’ instead of waiting and waiting and waiting. So if you start very, very early on, you will of course have better success, because the person was not (extremely) sick from the start. “
Dr. Bob Hughes, Village Medical’s National Medical Director for Rural Health and Murray State University’s Chief Medical Officer, agreed that the bottom line for patients on ventilators is usually not good because their cases are so severe when they are treated.
“There are several steps you take before you get on the ventilator and (doctors across the country) have tried numerous things to keep people off the ventilators,” said Hughes. “No. 1 is the rates of oxygen that I’ve never seen in my career in terms of high flow rate. No. 2, (I’ve never seen before) doctors who lay people on their stomachs. They just do anything to keep them away from a ventilator, because the ventilator was originally thought to put a lot of pressure and a lot of air through your lungs. This is of course necessary to maintain oxygen levels, but then of course the coronavirus spreads in all sorts of areas too The mortality rates – initially (early in the pandemic) and now – have always stayed at 50 to 70% when you put on the ventilator.
“Well, I’d guess the variability is based on # 1 where the study came from?” Said Hughes. “No. 2, what was the level of care? Was it a center for tertiary care and more of a critical access hospital or a smaller hospital?”
Hughes said doctors across the country still haven’t found very effective treatments for COVID patients who have reached the stage where they would need a ventilator. One possibility is for the patient to deteriorate to the point where their lungs are destroyed. You could have a lung transplant at this point, but Hughes said that was rare. The other most likely possibility is that the patient will succumb to the disease and die, he said.
“That hasn’t changed since we saw this in March and April 2020 (during the first wave of the pandemic),” said Hughes. “Much of this is determined by other comorbidity factors, but as we see with this second wave, the people who get it are on average 15 years younger (than they were with the first wave). The sad thing is that they don’t necessarily have to have two to five other comorbidities. “
Hughes said that even if someone survived after being put on a ventilator, they could still face long-term and potentially lifelong effects like a significant amount of fibrosis in their lungs or significant loss of lung tissue. He referred to a recent article that said a person’s lungs looked like “chewed gum” before a lung transplant.
“If that doesn’t scare anyone into getting a vaccine, I don’t know what happens,” he said.
source https://www.bisayanews.com/2021/09/30/health-officials-ventilator-mortality-rate-high-because-of-severity-of-covid-19-patient-illness-local-news/
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