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How many of my colleagues are seeing the following. . .
1. We are incubating and starting positive pressure ventilation later, when respiratory fatigue is present, not just hypoxemia
2. Patients often breathe with high-flow nasal oxygen for weeks
How many of my colleagues are seeing the following. . .
1. We are incubating and starting positive pressure ventilation later, when respiratory fatigue is present, not just hypoxemia
2. Patients often breathe with high-flow nasal oxygen for weeks
3. They’re received remdesivir, steroids, tocilizumab, heparin, etc.already
4. Then they tire and need positive pressure assistance
5. We put them on the vent and they have very stiff lungs
6. We put them on the vent without offering a new restorative treatment.
4. Then they tire and need positive pressure assistance
5. We put them on the vent and they have very stiff lungs
6. We put them on the vent without offering a new restorative treatment.
7. They require deep sedation or neuromuscular blockade to maintain coordination with the ventilator (so much reverse triggering, so much)
8. They have hypercapnea despite high minute ventilation
8. They have hypercapnea despite high minute ventilation
9. It feels futile, or worse,cruel, because we don’t have treatments to offer that have a high chance of making their lungs better
10. Tincture of time might work, but then their bodies are devastated from the weeks of sedation, paralysis, etc.
11. They’re not ECMO candidates
10. Tincture of time might work, but then their bodies are devastated from the weeks of sedation, paralysis, etc.
11. They’re not ECMO candidates
How do we resolve this dilemma?
