https://abcnews.go.com/Health/coronavirus-dilemma-ventilators/story?id=70124392
These challenges have prompted some physicians and medical groups to publicly question the value of using ventilators early and often among patients with COVID-19.
So are we using ventilators too much? Right now, the answer is complicated.
Some have argued that less invasive ways of supporting breathing may be just as good, and avoid the undesirable complications that come with using a ventilator.
A study of critically ill patients with COVID-19 in Wuhan, China, found that for those in severe respiratory failure, use of a non-invasive method of ventilation, called "high flow nasal cannula," was effective in preventing doctors from needing to use a ventilator on a majority of these patients. High flow nasal cannula is a method of oxygen delivery where a small plastic prong is fitted into each nostril and blows in oxygen at a high flow rate.
Another method, called "helmet non-invasive ventilation," also seems to help avoid the need for a ventilator. Use of this method was seen during the Italian epidemic, but it is not widely used in the United States.
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While a ventilator is often the best or only option left when a patient's oxygen gets critically low, there has been shifting consensus about the right time to put a patient on a ventilator. Early on, multiple studies and guidelines lauded early transition to a ventilator as a "best practice" for COVID-19. However, that opinion has been shifting as physicians learn more about the virus and how it affects the lungs.
Now, some believe that delaying ventilator use may actually be preferred, particularly given the inherent risks that come with ventilator use, such as lung damage and infections. A recently published article in the American Journal of Respiratory and Critical Care Medicine detailed how some patients with COVID-19 don't seem to benefit from a ventilator, even when their blood oxygen levels are low.
Another recent article published in the Journal of the American Medical Association showed similar findings among patients with COVID-19 in Italy.