Thursday, May 18, 2023

“What am I going to do with 400 ventilators when I need 30,000?"


Aggressive use of ventilators may have killed some Covid patients, a new paper from Northwestern University researchers suggests. 

Covid itself has a “relatively low mortality rate" compared to other respiratory illnesses, the researchers found after examining about 600 patients with severe pneumonia. Yet Covid patients remained intubated longer than other patients and developed secondary bacterial infections more often. 

Those extra infections caused many deaths in Covid patients, the researchers wrote. More patients may have died from the bacterial infections than Covid itself. 

The new finding is particularly troubling because media outlets and hospitals both pressed ventilator use for Covid patients in 2020, frequently claiming ventilator shortages were likely.

Reporters focused on ventilators as a way to criticize the Trump Administration’s pandemic response. A Politico headline from March 27, 2020 summed up the media’s attitude:

Trump: I don’t believe you really need that many ventilators

Meanwhile, hospitals encouraged early ventilator use in part to protect their staffs from Covid. 

“Doctors often put preemptively put patients on ventilators,” the Wall Street Journal reported in December 2020. Compared to patients on less intrusive forms of breathing support, ventilated patients exhale - or “aerosolize” - far fewer Covid viral particles. 

But ventilation is dangerous for patients, especially when it goes on for long periods. Tracheostomy tubes are a highway to bacterial lung infections, or “ventilator-acquired pneumonia,” which can be very difficult to treat, even with powerful antibiotics. 

“The importance of VAP [ventilator-acquired pneumonia] as a driver of mortality in patients with COVID-19 has been underestimated,” the researchers wrote. 

The paper was published in the Journal of Clinical Investigation in late April and examined 585 patients with severe pneumonia treated at Northwestern’s hospital, including 190 Covid patients.

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AND THEN THERE'S THIS:


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