Doctors say they are not rushing to intubate coronavirus patients as quickly as they were a month ago.
Many New York doctors are reducing the use of ventilators and turning to other methods to help patients breathe, The New York Times reports.
“What we thought we knew, we don’t know,” Dr. Nile Cemalovic, an intensive care physician at Lincoln Medical Center in the Bronx, told the newspaper.
Instead of sedating COVID-19 patients with low oxygen levels and hooking them up to mechanical ventilators, many doctors are keeping patients conscious and moving. They have patients rolling over in bed, reclining in chairs and breathing on their own with some additional oxygen.
The method is called proning and it involves a patient rolling onto their sides or on their bellies while receiving oxygen. The goal is to increase lung function by keeping patients off of their backs.
The number of patients being intubated is increasing at a rate of about 21 per day, which is down from about 300 per day at the end of March, according to The New York Times.
Some doctors have started using special massage mattresses designed for pregnant women that feature cutouts to ease the load on the belly and chest. Other techniques doctors have tried include using CPAP breathing machines, normally used to help people with sleep apnea.
Another Lincoln Hospital physician, Dr. Nicholas Caputo, told the newspaper that if he could go back to early March he would tell himself and other doctors, “Don’t jump to intubation.”
Dr. Caputo followed 50 patients who arrived with low oxygen levels between 69 and 85% (95% is normal). After five minutes of proning, patients had improved to an average of 94%. Over the next 24 hours, nearly three-quarters were able to avoid intubation and just 13 needed ventilators, he said.
Several doctors agree that the proning technique doesn’t work well in older patients and that some critically ill patients will still require a ventilator.
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