Thursday, 16.04.2020 – Are Ventilators Overused?

Link of the day: With ventilators running out, doctors say the machines are overused for Covid-19

There is some evidence suggesting that too many patients are put on ventilators earlier than would be optimal for them. Ventilation means that the patient has to be sedated the entire time and the pressure applied by the ventilator machine can cause long term damage to the lung. Alternatives include various forms of non-invasive ventilation (NIV) like giving the patient a constant high flow of oxygen to breath or Bilevel Positive Airway Pressure (BIPAP).

There are good reasons for putting patients on a respirator even though it is not strictly necessary (or even sub-optimal) from a medical point of view: These machines provide a closed system, whereas NIV has a much higher risk of leakage that leads to contaminated aerosols flowing around. Mechanical ventilation therefore is somewhat safer and easier to manage for medical staff. Nevertheless: maybe it is time to change course and explore other options?

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