Doctors Suspect Mystery COVID-19 Lung Problems, Plea for New Approach https://www.medicinenet.com/script/main/art.asp?articlekey=230110
By Peter Schelden <https://www.medicinenet.com/script/main/art.asp?articlekey=224344> on 04/09/2020 2:00 PM Source: MedicineNet Health News Some doctors are questioning the way ventilators are being used for people with serious cases of COVID-19 <https://www.medicinenet.com/wuhan_coronavirus_2019-ncov/article.htm>. Why? More data shows a high death rate for patients treated under current ventilator practices. At the same time, these doctors are saying their patients behave more like they have high altitude sickness than a viral infection. They talk about two different types of COVID-19 <https://www.medicinenet.com/wuhan_coronavirus_outbreak_2019-ncov/article.htm> patients with differing severe lung problems. While some patients respond to treatment as expected, doctors also describe patients whose lungs <https://www.medicinenet.com/image-collection/lungs_picture/picture.htm> seem relatively fine, but who still can't get enough oxygen into their blood. These patients may make up the majority with severe infections. This is why some are asking other doctors to consider changing how they treat some people in severe condition from COVID-19 <https://www.medicinenet.com/wuhan_coronavirus_2019-ncov_symptoms_and_signs/symptoms.htm> . This conflict in treatment approaches shows in real time how doctors are adjusting their tactics against a novel and dangerous infection. And it shows the persistence and diligence necessary to shift the medical establishment's practices once a treatment protocol has been established, even when evidence begins to show that treatment is less effective than once believed. NY Doctor Finds Odd Lung Patterns Assessing the outcomes of COVID-19 patients on ventilators, Brooklyn emergency room physician Dr. Cameron Kyle-Sidell found worse outcomes than expected. He told Medscape that around 70% of COVID-19 patients on ventilators never recover, based on his research. What's more, the doctor noticed disturbing patterns he had never seen before. COVID-19 patients on ventilators sometimes showed extremely low blood-oxygen concentrations during ventilation, he said. Despite doctors' best efforts, he reported seeing concentrations of oxygen in blood at 10% to 20%, and sometimes even lower – a healthy blood oxygen level is above 95 percent, according to the British Lung Foundation. Not only that, but some COVID-19 patients seem less obviously impaired by their low blood oxygen levels than he expected. "In the past, we haven't seen patients who are talking in full sentences and not complaining of overt shortness of breath <https://www.medicinenet.com/shortness_of_breath/symptoms.htm>, with (blood oxygen) saturations in the high 70s," he said. "You get used to seeing certain patterns, and the patterns I was seeing did not make sense." How Successful Are Ventilators for COVID-19? Doctors and scientists studying the mortality rate of COVID-19 patients on mechanical ventilators say the available data is tricky to assess. Some studies put the death rate for coronavirus patients put on ventilators as low as 25%. But many report much higher rates, ranging anywhere from about 50% to as high as 98% in one instance. For example, in a UK study of 98 COVID-19 patients who received "advanced respiratory support," which included invasive ventilation and tracheostomy <https://www.medicinenet.com/tracheostomy/article.htm>, 66% died, according to the nation's Intensive Care National Audit and Research Center (ICNARC). New York City hospitals have reported an even higher COVID-19 ventilator death rate. Roughly 80% or more of patients placed on ventilators there have died, according to AP News. The agency reports that typically only about 40% to 50% of patients on ventilators for non-COVID-19-related lung problems die. The percentage is high compared with the prognosis for some other medical procedures because, in general, doctors hold off on administering invasive ventilation until it is medically necessary, which means the illness is already quite serious before intubation <https://www.medicinenet.com/endotracheal_intubation/article.htm>. Though data continue to emerge, some doctors feel enough already exists to justify new approaches to treating the most serious COVID-19 cases. *Click on the link for the rest.* -- If you appreciate News From Underground, please consider making a donation — either a one-time gift or a monthly subscription: http://markcrispinmiller.com/support/ Thank you for your support. 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