Tags: Coronavirus | Health Topics | covid-19 | ventilators | respiratory distress

Doctors Question Use of Ventilators, Ask If We Are Treating the Wrong Disease

a mechanical ventilator
A mechanical ventilator on display in New York City. (Mark Lennihan/AP)

By    |   Thursday, 16 April 2020 01:21 PM

The mortality rate of COVID-19 patients who have been put on ventilators is a staggering 60-80%. According to experts, high-pressure ventilation to treat complications caused by the disease can be damaging to the lungs.

In X-rays, you can see the lungs of COVID-19 patients deteriorate after the procedure.

So, what's going wrong? Experts say doctors are treating patients according to the protocol established for Adult Respiratory Distress Syndrome (ARDS). But COVID-19 Adults Respiratory Distress Syndrome (CARDS) may be an entirely different disease.

"It's something we've never seen before," Dr. Stuart H. Ditchek, MD, who is part of the Pandemic Task Force Working Group and an attending physician at NYU-Langone Medical Center in New York City, tells Newsmax. "In ARDS patients, when we take X-rays of their lungs after they have been ventilated, their lungs improve. Not so with most of the COVID-19 patients."

Ditchek's colleague, Dr. Cameron Kyle-Sidell, MD, who is board certified in critical care medicine, puts it bluntly:

"We are treating the wrong disease," he says in a video for Global Research. "This is not classical ARDS and we're using a false paradigm to treat COVID-19. I feel that continuing to use misguided treatment will lead to a tremendous amount of suffering in a very short time."

Ditchek says that several radiologists suggest that the serial radiographs of COVID-19 patients resemble the pattern of premature infants' respiratory syndrome (RDS) rather than ARDS.

"Should we start to view COVID-19 patients as suffering from a similar pathology to infant RDS and attempt the successful interventions used in those children?" asks Ditchek. "Clearly we need to be trying something else and by using these proven interventions on even some of the patients we can actually be conducting our own trials right here, right now."

What Ditchek proposes has already rocked the academic community, which wants clinical trials before changing protocol.

"We are kind of flying by the seat of our pants, so we don't have time to follow the old rules," he counters. "We do know that high-pressure ventilation seems to be further damaging the lungs and causing a cytokine storm, which attacks and limits oxygenation. So, we need to try other methods to safely save these patients."

Here what the doctors recommend:

  1. Use High-Frequency Oscillatory Ventilation (HFOV), which is a gentler approach and more likely to be lung protective. It's been used successfully in infant RDS for many years.
  2. Employ noninvasive positive pressure ventilation (NIPPV) techniques such as high-flow nasal canula (HFNC), helmet masks, and BIPAP and CPAP devices for as long as possible
  3. Initiate surfactant therapy, which helps with oxygen exchange either through intubation or in a nebulizer.
  4. Use treatment options like hydroxychloroquine, remdesivir, and convalescent plasma treatment, among others, and include them in medical trials.

"A mortality rate of 60% to 80% in ventilated COVID-19 patients is simply not acceptable and should trigger an immediate review and changing paradigm," says Ditchek. "Centers should consider adopting any or all of these recommendations or at least start having important conversations for novel disease management."

© 2020 NewsmaxHealth. All rights reserved.


   
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The mortality rate of COVID-19 patients who have been put on ventilators is a staggering 60-80%. Two doctors said the ventilators themselves could be at least partially to blame.
covid-19, ventilators, respiratory distress
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2020-21-16
Thursday, 16 April 2020 01:21 PM
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